2025 CPT code 74300
Effective Date: N/A Radiology - Diagnostic Radiology Feed
Intraoperative radiological supervision and interpretation of cholangiography and/or pancreatography.
Modifiers 26, 52, 53, 76, 77, 79, TC are applicable where appropriate
Medical necessity is established by the clinical indication for the intraoperative cholangiogram or pancreatogram.This could include suspected choledocholithiasis, biliary obstruction, pancreatic masses, or other conditions requiring visualization of the bile and/or pancreatic ducts during surgery.
The physician providing this service is responsible for supervising the radiological portion of the procedure, including contrast injection and image acquisition, as well as interpreting the resulting images. This requires the physician's presence during the procedure.
In simple words: During a surgery, a doctor uses X-rays and dye to view the bile and pancreatic ducts to check for blockages or other problems. This code covers the doctor's work in supervising the X-ray process and interpreting the images.
This code represents the radiological supervision and interpretation of imaging performed during an intraoperative cholangiogram and/or pancreatogram.The procedure involves injecting contrast material into the bile and/or pancreatic ducts and obtaining images to visualize the anatomy and detect any abnormalities such as stones, tumors, or strictures. This code is reported by the provider who performs the imaging supervision and interpretation.
Example 1: During a laparoscopic cholecystectomy (gallbladder removal), the surgeon requests an intraoperative cholangiogram to assess for stones in the common bile duct. A radiologist supervises the injection of contrast and image acquisition, interprets the images, and communicates the findings to the surgeon., A patient undergoes an exploratory laparotomy for abdominal pain. During the procedure, the surgeon identifies a pancreatic mass and requests an intraoperative pancreatogram.A radiologist supervises the imaging and provides interpretation to determine the extent of the mass and its relationship to the pancreatic duct., During an ERCP, a gastroenterologist performs a cholangiogram and a pancreatogram to evaluate a patient with jaundice. The gastroenterologist supervises the imaging and interprets the images in real-time to guide the procedure and determine the cause of the jaundice.
Documentation should include details of the intraoperative imaging, including the type of contrast used, number of images taken, and the radiologist's interpretation report. The report should describe the findings, including the anatomy of the biliary and/or pancreatic ducts, and any identified abnormalities.
** For services paid under OPPS, Medicare does not pay hospitals separately for supervision and interpretation codes considered ancillary to primary services. However, hospitals should still report the code for statistical purposes.