How To Use CPT Code 74415

CPT 74415 describes the procedure of urography with nephrotomography, which involves the use of X-ray imaging to examine the kidneys, ureters, and bladder after a rapid bolus injection of contrast material. 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 74415?

CPT 74415 is used to describe the procedure of urography with nephrotomography. This procedure involves the use of X-ray imaging to examine the kidneys, ureters, and bladder after a rapid bolus injection of contrast material. It allows for the visualization of the urinary tract and helps in the diagnosis of various conditions affecting the kidneys and urinary system.

2. Official Description

The official description of CPT code 74415 is: ‘Urography, infusion, drip technique and/or bolus technique; with nephrotomography.’ This code represents both the technical and professional components of the service.

3. Procedure

1. The provider administers a rapid bolus injection of contrast material into the patient’s veins.
2. After the contrast material reaches the kidneys and ureters, the provider performs an X-ray examination of the abdomen.
3. Nephrotomography is used to capture images of the kidneys, blurring out other organs to better visualize the kidneys.
4. The digital images are displayed on a computer screen for the provider to review and analyze.
5. The provider then prepares a written report of their findings based on the images.

4. Qualifying circumstances

CPT 74415 is performed when there is a need to visualize the kidneys, ureters, and bladder using urography with nephrotomography. This procedure is typically used to diagnose conditions such as ectopia, renal agenesis, acquired renal diseases, and other abnormalities affecting the urinary tract. The use of contrast material and the specific technique of nephrotomography differentiate this procedure from other imaging methods.

5. When to use CPT code 74415

CPT code 74415 should be used when performing urography with nephrotomography. It is appropriate when there is a need to visualize the kidneys, ureters, and bladder using X-ray imaging after a rapid bolus injection of contrast material. This code should not be used for CT imaging or other imaging methods that do not involve the specific technique of nephrotomography.

6. Documentation requirements

To support a claim for CPT 74415, the provider must document the following information:

• Indication for the procedure and the medical necessity
• Details of the contrast material used and the route of administration
• Date and time of the procedure
• Specific technique used, including nephrotomography
• Findings and diagnostic interpretation
• Written report of the findings

7. Billing guidelines

When billing for CPT 74415, ensure that the procedure performed includes urography with nephrotomography. It is important to use the appropriate code based on the specific technique used. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, and modifier TC should be appended if reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC. For global services where one provider renders both the professional and technical components, no modifier is necessary.

8. Historical information

CPT 74415 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes urography with nephrotomography to evaluate a suspected renal abnormality.
2. A provider performs urography with nephrotomography on a patient with a history of renal agenesis.
3. Urography with nephrotomography is performed on a patient to assess the effectiveness of a previous surgical intervention on the urinary tract.
4. A provider uses urography with nephrotomography to diagnose a patient with ectopia of the kidneys.
5. A patient undergoes urography with nephrotomography to evaluate the presence of acquired renal diseases.
6. Urography with nephrotomography is performed on a patient with recurrent urinary tract infections to identify any underlying abnormalities.
7. A provider uses urography with nephrotomography to assess the function and structure of the kidneys in a patient with chronic kidney disease.
8. A patient undergoes urography with nephrotomography to evaluate the presence of kidney stones.
9. Urography with nephrotomography is performed on a patient with hematuria to identify the source of bleeding in the urinary tract.
10. A provider uses urography with nephrotomography to assess the response to treatment in a patient with a known urinary tract abnormality.