2025 CPT code 74420
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Radiology - Urography Diagnostic Radiology (Diagnostic Imaging) Procedures of the Urinary Tract Feed
Retrograde urography (pyelography) with or without KUB, imaging the urinary tract to detect obstructions.
Modifiers -26 and TC are applicable depending on the services rendered.-26 is appended when only professional services are billed, while TC is for the technical component.Other modifiers may be applicable depending on the specific clinical scenario.
Medical necessity is established when there is a clinical indication for imaging the upper urinary tract to evaluate for obstruction, evaluate for anatomical abnormalities, or assess for the cause of recurrent urinary tract infections. The presence of symptoms such as flank pain, hematuria, or hydronephrosis typically warrants the procedure.
The clinical responsibility may be shared between a urologist (inserting the catheter and contrast) and a radiologist (taking and interpreting the images). The specific responsibilities will depend on the setting and the providers involved.
- Diagnostic Radiology (Diagnostic Imaging) Procedures of the Urinary Tract
- Diagnostic Radiology (Diagnostic Imaging) Procedures of the Urinary Tract
In simple words: This X-ray test uses a special dye injected into the kidneys and ureters through a thin tube to create detailed pictures of these organs.It helps doctors find blockages or problems in the urinary tract.
Retrograde urography, also known as retrograde pyelography, is an X-ray examination of the urinary tract (kidneys, ureters, and bladder) using contrast material introduced via a catheter against the normal urine flow.The procedure is used to visualize the upper urinary tract and detect obstructions such as kidney stones or strictures.A KUB (kidney, ureter, bladder) X-ray may or may not be performed in conjunction with this procedure. This code encompasses both the technical and professional components of the service. The contrast medium is inserted through a catheter into the ureter, flowing up to the kidneys. The flow of contrast helps identify any obstructions present. The images are then examined to assess the location and size of any blockage.
Example 1: A patient presents with severe flank pain and suspected kidney stone.Retrograde urography is performed to visualize the ureter and identify the location and size of the stone., A patient with a history of recurrent urinary tract infections undergoes retrograde urography to assess for any underlying anatomical abnormalities or obstructions., Post-operative assessment following ureteral surgery to check for any stricture formation or obstruction.
A detailed history and physical examination focusing on urinary symptoms.Pre-procedure consent form.Radiology report including image interpretation, contrast used, and any findings.If performed in conjunction with a KUB, the KUB report should also be included.
** The KUB (kidney, ureter, and bladder) portion of the code is optional.Billing practices and modifier usage may vary based on the setting of service (e.g., hospital vs. private office) and the responsibilities of the physician.Always consult current CPT guidelines and payer policies for accurate billing practices.
- Revenue Code: I1F (STANDARD IMAGING - OTHER)
- RVU: This information is not available in the provided text.RVUs vary based on geographic location and payer.
- Global Days: This information is not available in the provided text.Global period will depend on payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: Modifier TC applies when only the technical component (image acquisition) is billed. Usually the hospital bills for this.Physicians generally bill for professional interpretation (-26).
- Fee Schedule: This information is not available in the provided text. Consult your local Medicare fee schedule and private payer fee schedules.
- Specialties:Urology, Radiology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center