How To Use CPT Code 74355

CPT 74355 describes the percutaneous placement of an enteroclysis tube with radiological supervision and interpretation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74355?

CPT 74355 can be used to report the radiological supervision and interpretation for the percutaneous placement of an enteroclysis tube. This procedure involves the placement of a tube through the abdomen to allow imaging of the small intestine, typically done using fluoroscopy. The code represents only the imaging supervision and interpretation for this procedure.

2. Official Description

The official description of CPT code 74355 is: ‘Percutaneous placement of enteroclysis tube, radiological supervision and interpretation.’

3. Procedure

1. The provider performs radiological supervision during the placement of an enteroclysis tube to examine the small intestine or provide visualization for a procedure on the small intestine.
2. The provider makes an abdominal incision and carefully dissects the subcutaneous tissues.
3. The small bowel is mobilized, and a location in the jejunum is selected.
4. The provider incises the bowel and inserts a tube into the small bowel.
5. The provider performs imaging supervision and interpretation for the procedure, ensuring proper tube placement and visualization of the small intestine.

4. Qualifying circumstances

CPT 74355 is used when the provider performs radiological supervision and interpretation for the percutaneous placement of an enteroclysis tube. This procedure is typically done to examine the small intestine or provide visualization for a procedure on the small intestine. The enteroclysis tube is placed in the small bowel, often used for injection of contrast and imaging. Fluoroscopy, a live X-ray imaging technique, is commonly used during the procedure.

5. When to use CPT code 74355

CPT code 74355 should be used to report the radiological supervision and interpretation for the percutaneous placement of an enteroclysis tube. It should not be used to report the actual placement of the tube or any other procedures performed during the same session. This code represents only the imaging component of the procedure.

6. Documentation requirements

To support a claim for CPT 74355, the provider must document the following information:

• Indication for the procedure and the need for radiological supervision and interpretation
• Details of the procedure, including the approach used and any complications encountered
• Date and time of the procedure
• Specific findings and observations made during the imaging supervision and interpretation
• Signature of the provider performing the imaging supervision and interpretation

7. Billing guidelines

When billing for CPT 74355, ensure that the provider is reporting only the radiological supervision and interpretation component of the procedure. If multiple providers are involved, each should report the code with reduced service modifier 52 and append modifier 26 to indicate the professional component. If reporting only the physician’s interpretation, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. Note that payer policies may vary, and hospitals may be exempt from appending modifier TC. It is important to follow the specific guidelines of the payer.

8. Historical information

CPT 74355 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A radiologist performs imaging supervision and interpretation for the percutaneous placement of an enteroclysis tube to visualize the small intestine in a patient with suspected Crohn’s disease.
2. During a fluoroscopy-guided procedure, a gastroenterologist places an enteroclysis tube to inject contrast and obtain images of the small intestine. A radiologist provides the imaging supervision and interpretation for the procedure.
3. A surgeon performs the percutaneous placement of an enteroclysis tube to examine the small intestine in a patient with unexplained abdominal pain. A radiologist is present to provide the necessary imaging supervision and interpretation.
4. Using fluoroscopy, an interventional radiologist guides the placement of an enteroclysis tube to visualize the small intestine for a subsequent therapeutic procedure. The radiologist also performs the imaging supervision and interpretation for the tube placement.
5. A pediatric radiologist provides the imaging supervision and interpretation for the percutaneous placement of an enteroclysis tube in a child with suspected malabsorption syndrome.