How To Use CPT Code 74425

CPT 74425 describes the radiological supervision and interpretation for an antegrade urography examination. 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 74425?

CPT 74425 can be used to describe the radiological supervision and interpretation for an antegrade urography examination. This procedure involves injecting contrast in the direction of the normal flow of fluids inside the urinary tract and then taking radiographs to assess for any ureteric obstruction.

2. Official Description

The official description of CPT code 74425 is: ‘Urography, antegrade, radiological supervision and interpretation.’

3. Procedure

1. The provider performs antegrade urography, also known as antegrade pyelogram, to identify any known or suspected ureteric obstruction in patients.
2. Using fluoroscopic guidance, the provider enters the pelvicaliceal system percutaneously using a small-bore needle.
3. The provider then injects contrast in the direction of the normal flow of fluids inside the urinary tract.
4. Radiographs are taken to observe the flow pattern of the contrast material and assess the location and size of any obstruction.
5. Based on the findings, the provider determines the further plan of treatment.

4. Qualifying circumstances

CPT 74425 is used when the provider performs radiological supervision and interpretation for an antegrade urography examination. This procedure is typically done to identify ureteric obstruction in patients.

5. When to use CPT code 74425

CPT code 74425 should be used when the provider performs radiological supervision and interpretation for an antegrade urography examination. It is important to note that this code should not be reported in conjunction with certain other codes, as specified in the notes.

6. Documentation requirements

To support a claim for CPT 74425, the provider must document the following information:

• Indication for the antegrade urography examination
• Details of the procedure performed, including the injection of contrast and the radiographs taken
• Findings and assessment of any ureteric obstruction
• Plan of treatment based on the findings
• Signature of the provider performing the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74425, ensure that the provider is performing radiological supervision and interpretation for an antegrade urography examination. It is important to follow the guidelines and notes provided to determine if any other codes should or should not be reported in conjunction with CPT 74425. Additionally, modifiers may need to be appended to the code based on payer policies and the specific circumstances of the service.

8. Historical information

CPT 74425 was added to the Current Procedural Terminology system on January 1, 1990. There have been changes to the code over the years, including updates to the description and the addition of notes.

9. Examples

1. A radiologist performing radiological supervision and interpretation for an antegrade urography examination to assess for ureteric obstruction in a patient with recurrent urinary tract infections.
2. A urologist injecting contrast in the direction of the normal flow of fluids inside the urinary tract and taking radiographs to evaluate a suspected ureteric obstruction in a patient with hematuria.
3. A nephrologist performing radiological supervision and interpretation for an antegrade urography examination to assess for ureteric obstruction in a patient with hydronephrosis.
4. A interventional radiologist injecting contrast in the direction of the normal flow of fluids inside the urinary tract and taking radiographs to evaluate a known ureteric obstruction in a patient with renal colic.
5. A urologist performing radiological supervision and interpretation for an antegrade urography examination to assess for ureteric obstruction in a patient with a history of kidney stones.
6. A radiologist injecting contrast in the direction of the normal flow of fluids inside the urinary tract and taking radiographs to evaluate a suspected ureteric obstruction in a patient with flank pain.
7. A nephrologist performing radiological supervision and interpretation for an antegrade urography examination to assess for ureteric obstruction in a patient with a history of bladder cancer.
8. An interventional radiologist injecting contrast in the direction of the normal flow of fluids inside the urinary tract and taking radiographs to evaluate a known ureteric obstruction in a patient with renal insufficiency.
9. A urologist performing radiological supervision and interpretation for an antegrade urography examination to assess for ureteric obstruction in a patient with recurrent kidney infections.
10. A radiologist injecting contrast in the direction of the normal flow of fluids inside the urinary tract and taking radiographs to evaluate a suspected ureteric obstruction in a patient with urinary retention.