How To Use CPT Code 74485

CPT 74485 describes the radiological supervision and interpretation for the dilation of the ureters or urethra. 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 74485?

CPT 74485 can be used to describe the radiological supervision and interpretation for the dilation of the ureters or urethra. This code represents both the technical and professional components of the service, and it should be reported to represent only the imaging supervision and interpretation for this procedure.

2. Official Description

The official description of CPT code 74485 is: ‘Dilation of ureter(s) or urethra, radiological supervision and interpretation.’

3. Procedure

1. The provider performs imaging supervision and interpretation for the dilation of the ureters or urethra.
2. The patient is appropriately prepped and anesthetized.
3. Under fluoroscopic guidance, the provider dilates the ureters or urethra by inserting dilators of increasing sizes over a guidewire into the narrowed structure.
4. A balloon catheter is then passed over the guidewire until reaching the stricture (narrowing), and it is inflated to dilate the stricture.

4. Qualifying circumstances

CPT 74485 should not be reported in conjunction with codes 50436 and 50437. For dilation of the ureter without radiologic guidance, use codes 52341 and 52344. This code is also not appropriate for the change of nephrostomy or pyelostomy tube, which should be reported using code 50435. Additionally, for the dilation of a nephrostomy tract for an endourologic procedure, refer to codes 50436 and 50437.

5. When to use CPT code 74485

CPT code 74485 should be used when the provider performs the radiological supervision and interpretation for the dilation of the ureters or urethra. It is important to note that this code represents only the imaging component of the procedure.

6. Documentation requirements

To support a claim for CPT 74485, the provider must document the following information:

• Patient’s diagnosis and the need for the dilation procedure
• Details of the procedure, including the use of fluoroscopic guidance and the specific steps taken
• Date and time of the procedure
• Progress made during the procedure and any complications encountered
• Signature of the provider performing the radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 74485, ensure that the provider is reporting both the technical and professional components of the service. If reporting only the professional component, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, it is important to check payer policies, as hospitals may be exempt from appending modifier TC. It is also 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. Therefore, reporting this code for statistical purposes is still necessary.

8. Historical information

CPT 74485 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2019 to include the dilation of nephrostomy, ureters, or urethra under radiological supervision and interpretation.

9. Examples

1. A radiologist performing the imaging supervision and interpretation for the dilation of a patient’s ureters.
2. A urologist using fluoroscopic guidance to dilate a patient’s urethra and a radiologist interpreting the images.
3. A nephrologist performing the radiological supervision and interpretation for the dilation of a patient’s nephrostomy tract.
4. An interventional radiologist dilating a patient’s ureters under fluoroscopic guidance and another radiologist interpreting the images.
5. A urogynecologist performing the imaging supervision and interpretation for the dilation of a patient’s urethra.
6. A radiologist using fluoroscopic guidance to dilate a patient’s ureters and a urologist interpreting the images.
7. A urologist performing the radiological supervision and interpretation for the dilation of a patient’s urethra.
8. An interventional radiologist dilating a patient’s nephrostomy tract under fluoroscopic guidance and another radiologist interpreting the images.
9. A urogynecologist using fluoroscopic guidance to dilate a patient’s urethra and a radiologist interpreting the images.
10. A nephrologist performing the imaging supervision and interpretation for the dilation of a patient’s ureters.