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Cholangiography and pancreatography are specialized imaging procedures utilized to visualize the bile ducts and pancreatic duct, respectively. These procedures are essential during biliary surgery, particularly for identifying issues such as stones, inflammation, or obstructions within the bile ducts, as well as assessing the pancreatic duct for any trauma. The process typically involves the surgeon placing a small catheter into the cystic duct after the gallbladder has been removed. The cystic duct is responsible for draining bile from the gallbladder into the common bile duct, while the pancreatic duct merges with the common bile duct just before entering the ampulla of Vater. To capture detailed images of these structures, X-ray imaging is employed, which utilizes indirect ionizing radiation. This method is effective for visualizing non-uniform materials, such as human tissue, due to the varying densities and compositions that allow some X-rays to be absorbed while others pass through, resulting in a two-dimensional image on a detector. To enhance the clarity and definition of the anatomical structures and their functions, a contrast material is injected into the duct(s). The entire procedure is conducted under the direct supervision of a radiologist, who oversees the contrast injection and provides a report of the findings to the surgeon. The CPT® Code 74300 is designated for reporting the radiological supervision and interpretation of the initial cholangiography or pancreatography study performed intraoperatively, while CPT® Code 74301 is specifically used to report any additional image sets obtained during the same intraoperative session.
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The indications for performing cholangiography and/or pancreatography include the following:
The procedure for cholangiography and/or pancreatography involves several key steps, which are detailed as follows:
Post-procedure care involves monitoring the patient for any immediate complications related to the cholangiography and/or pancreatography. The surgical team will assess the patient's recovery from anesthesia and ensure that vital signs are stable. Any findings reported by the radiologist will be discussed with the surgical team to determine if further intervention is necessary. Patients may be advised on dietary restrictions or follow-up imaging based on the results of the procedure. Overall, the recovery process will depend on the individual patient's condition and the extent of the surgical procedure performed.
| Short Descr | X-RAYS AT SURGERY ADD-ON | Medium Descr | CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS | Long Descr | Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1D - Standard imaging - contrast gastrointestinal | MUE | 1 | CCS Clinical Classification | 184 - Intraoperative cholangiogram |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 74300 | MPFS Status: Carrier Priced APC N ASC N1 Physician Quality Reporting PUB 100 CPT Assistant Article Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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