How To Use CPT Code 74445

CPT 74445 describes the radiological supervision and interpretation of corpora cavernosography, a procedure used to evaluate venogenic impotence and diagnose organic erectile dysfunction. 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 74445?

CPT 74445 is used to represent the radiological supervision and interpretation of corpora cavernosography. This procedure involves the insertion of needles into the corpora cavernosa, followed by the injection of contrast material to keep the penis erect for X-ray imaging. The provider uses fluoroscopy to detect any venous leakage or structural abnormalities in the corpora cavernosa. It is performed to evaluate venogenic impotence and diagnose organic erectile dysfunction.

2. Official Description

The official description of CPT code 74445 is: ‘Corpora cavernosography, radiological supervision and interpretation.’

3. Procedure

1. The provider inserts needles into the corpora cavernosa after the patient is appropriately prepped and anesthetized.
2. Contrast material is injected at a specific pressure to keep the penis erect for X-ray imaging.
3. X-ray images are taken to evaluate the corpora cavernosa and detect any venous leakage or structural abnormalities.
4. Fluoroscopy is used to enhance visualization of the body structures during the procedure.
5. The provider interprets the imaging results and makes a diagnosis based on the findings.

4. Qualifying circumstances

CPT 74445 is performed to evaluate venogenic impotence, which is impotence caused by disorders in the veins that occlude to keep the penis erect. It is also used to diagnose organic erectile dysfunction resulting from structural abnormalities in the corpora cavernosa. This procedure is typically performed by a provider who specializes in radiological supervision and interpretation.

5. When to use CPT code 74445

CPT code 74445 should be used when a provider performs the radiological supervision and interpretation of corpora cavernosography. It is important to note that this code represents only the imaging supervision and interpretation for this procedure and should not be reported for other components of the service.

6. Documentation requirements

To support a claim for CPT 74445, the provider must document the following information:

• Indication for the procedure, such as evaluation of venogenic impotence or diagnosis of organic erectile dysfunction
• Details of the procedure performed, including the use of contrast material and fluoroscopy
• Imaging findings and interpretation
• Diagnosis based on the imaging results
• Signature of the provider performing the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74445, ensure that the provider performing the service is qualified to perform radiological supervision and interpretation. It is important to note that Medicare does not pay hospitals separately for supervision and interpretation codes deemed to be ancillary and supportive services to primary diagnostic or therapeutic services. However, the code should still be reported for statistical purposes.

8. Historical information

CPT 74445 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 performing the radiological supervision and interpretation of corpora cavernosography to evaluate venogenic impotence in a patient with a history of trauma.
2. A urologist interpreting the imaging results of corpora cavernosography to diagnose organic erectile dysfunction in a patient with structural abnormalities in the corpora cavernosa.
3. A radiology technician assisting the provider during the corpora cavernosography procedure and capturing the X-ray images for radiological supervision and interpretation.
4. A healthcare facility reporting CPT 74445 for statistical purposes, even though Medicare does not provide separate reimbursement for supervision and interpretation codes.
5. A provider using fluoroscopy during corpora cavernosography to enhance visualization of the corpora cavernosa and detect any venous leakage or rupture.