How To Use CPT Code 74400

CPT 74400 describes the procedure known as urography or pyelography, which is used to evaluate the kidneys, ureters, and bladder. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74400?

CPT 74400 is used to describe a diagnostic radiology procedure called urography or pyelography. This procedure involves the evaluation of the kidneys, ureters, and bladder using X-ray imaging. The provider injects contrast material into the patient’s veins and may perform the procedure with or without a KUB (kidney, ureter, and bladder) X-ray and tomography.

2. Official Description

The official description of CPT code 74400 is: ‘Urography (pyelography), intravenous, with or without KUB, with or without tomography.’

3. Procedure

1. The provider performs an X-ray examination of the kidneys, ureters, and bladder before and after injecting contrast material into the patient’s veins.
2. The contrast material flows through the patient’s bloodstream and resides in the kidneys and urinary tract, allowing the provider to take X-ray images.
3. Using the X-ray images, the provider can assess the anatomy and function of the kidneys, ureters, and bladder.
4. The procedure may be performed with or without a KUB X-ray, which specifically focuses on the kidney, ureter, and bladder.
5. Tomography, which involves image reconstruction of two and three-dimensional objects, may also be performed during the procedure.

4. Qualifying circumstances

CPT 74400 is used for patients who require an evaluation of their kidneys, ureters, and bladder. The procedure is typically performed to diagnose and assess conditions related to the urinary tract. The provider must administer contrast material intravenously and may perform the procedure with or without a KUB X-ray and tomography.

5. When to use CPT code 74400

CPT code 74400 should be used when a provider performs urography or pyelography to evaluate the kidneys, ureters, and bladder. The procedure involves the injection of contrast material into the patient’s veins and may include a KUB X-ray and tomography. It is important to note that this code represents both the technical and professional components of the service.

6. Documentation requirements

To support a claim for CPT 74400, the provider must document the following information:

• Indication for the procedure and the need for an evaluation of the kidneys, ureters, and bladder
• Details of the contrast material used and its administration
• Date and time of the procedure
• Specific X-ray images taken before and after contrast administration
• Any additional imaging techniques used, such as KUB X-ray or tomography
• Interpretation and findings of the procedure
• Signature of the provider performing the service

7. Billing guidelines

When billing for CPT 74400, ensure that the procedure includes the evaluation of the kidneys, ureters, and bladder using intravenous contrast material. The use of a KUB X-ray and tomography may also be included. It is important to follow payer guidelines and append the appropriate modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, if applicable. If the provider performs both the professional and technical components, a global service code should be reported.

8. Historical information

CPT 74400 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 urography to evaluate a patient’s kidneys, ureters, and bladder using intravenous contrast material.
2. A urologist administers contrast material and performs urography with a KUB X-ray to assess a patient’s urinary tract.
3. A nephrologist utilizes tomography during urography to obtain detailed images of a patient’s kidneys, ureters, and bladder.
4. A radiology technician assists a radiologist in performing urography with contrast material and a KUB X-ray for a patient with suspected urinary tract abnormalities.
5. A urology resident performs urography with tomography to evaluate a patient’s kidney function and identify any potential obstructions.
6. A radiology team performs urography with contrast material and a KUB X-ray for a patient undergoing preoperative evaluation for kidney stone removal.
7. A radiologist interprets the images obtained from urography to diagnose a patient’s urinary tract infection.
8. A urologist performs urography with contrast material and tomography to assess the effectiveness of a patient’s previous kidney stone treatment.
9. A radiology technician prepares the contrast material and assists a radiologist in performing urography with a KUB X-ray for a pediatric patient with suspected urinary tract abnormalities.
10. A urology resident performs urography with contrast material and tomography to evaluate a patient’s urinary tract for potential tumors.