2025 CPT code 74328
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging Procedures - Diagnostic Radiology Radiology Feed
Radiological supervision and interpretation of endoscopic biliary duct catheterization.
Modifiers 26 (professional component), 52 (reduced services), and TC (technical component) may be applicable depending on the circumstances of service provision and payer requirements.
Medical necessity is established by the presence of clinical indications for endoscopic biliary duct catheterization, such as jaundice, elevated liver function tests, suspected biliary obstruction, or choledocholithiasis.The fluoroscopic guidance provided by the radiologist is crucial for the safe and effective completion of the procedure.
The radiologist is responsible for the radiological supervision and interpretation of the endoscopic biliary duct catheterization procedure. This involves monitoring the fluoroscopic images in real-time, guiding the placement of the catheter, and interpreting the images to identify any abnormalities.
In simple words: This code covers the doctor's job of watching and interpreting x-ray images during a procedure where a thin tube with a camera is put into the bile ducts. The doctor uses special dye to help see better on the x-ray, looking for problems like tumors or stones. This code is only for the doctor's part of looking at the x-rays, not the actual procedure.
This CPT code, 74328, represents the radiological supervision and interpretation of a separately reported endoscopic biliary duct catheterization.The procedure involves the use of fluoroscopy to visualize the biliary ducts during the insertion of an endoscope, the administration of contrast media, and the subsequent imaging assessment for abnormalities such as tumors, strictures, stones, or other structural issues. This code encompasses only the imaging supervision and interpretation; the endoscopic procedure itself is reported separately using codes 43260-43278 as appropriate.
Example 1: A patient presents with jaundice and elevated liver enzymes. An ERCP is performed, and the radiologist uses 74328 to report supervision and interpretation of the biliary ductal system fluoroscopy during catheter placement., A patient with a history of choledocholithiasis undergoes an ERCP. The radiologist uses code 74328 to bill for supervision and interpretation of the fluoroscopic images during the procedure, which reveals several stones requiring removal., A patient with suspected biliary stricture undergoes an ERCP. The radiologist uses 74328 to bill for the radiological supervision and interpretation during the placement of a biliary stent.Fluoroscopic images are used to guide placement and assess patency.
Complete documentation should include the pre-procedure and post-procedure imaging reports, detailed notes from the endoscopist regarding the procedure performed, and any relevant clinical findings.The report should clearly indicate that the radiologist provided both supervision and interpretation of the fluoroscopic images.
** This code should only be reported when the radiological supervision and interpretation are performed by a physician distinct from the individual performing the endoscopic procedure.If both services are performed by the same physician, this code should not be reported.
- Revenue Code: I1D (STANDARD IMAGING - CONTRAST GASTROINTESTINAL)
- Payment Status: Active
- Modifier TC rule: Modifier TC may apply if only the technical component of the radiological service was provided.However, payer policies may vary regarding modifier TC application for hospital-based radiology services.
- Specialties:Gastroenterology, Radiology, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center