2025 CPT code 74430

Radiological supervision and interpretation of a cystogram (minimum three views).

Adhere to current CPT coding guidelines for radiology services. Ensure the documentation fully supports the reported service.

Modifiers 26 (professional component) and TC (technical component) may be appended depending on the provider's role and payer requirements.Modifier 52 (reduced services) may be applicable in certain circumstances.

Medical necessity for a cystogram is established by a physician's order based on the patient's clinical presentation and symptoms, suggesting possible bladder pathology.This may include findings such as hematuria, lower abdominal pain, suspected trauma, or post-surgical assessment of bladder integrity.

The clinical responsibility lies with the radiologist who supervises the procedure and interprets the resulting images. This includes reviewing the images for signs of bladder rupture or leakage, and identifying any abnormalities such as infections, tumors, or stones.

IMPORTANT Modifiers 26 (professional component) and TC (technical component) may be appended depending on who performs which part of the procedure.If both components are provided by the same entity, no modifiers are needed.In cases of split billing, payer policies may vary.

In simple words: This code covers the doctor's review and interpretation of X-ray pictures of your bladder after a special dye has been used to make it easier to see.The doctor looks at at least three different X-ray images to check for problems.

This CPT code encompasses the radiological supervision and interpretation of a cystogram, involving a minimum of three views.The procedure includes imaging supervision and interpretation of X-ray images of the urinary bladder following the injection of contrast material. This is typically performed to evaluate bladder conditions like infections, tumors, or stones, and to assess for possible bladder rupture or leakage.

Example 1: A patient presents with suspected bladder infection.A cystogram is performed, and the radiologist (using code 74430) interprets the images to determine the extent of the infection and guide treatment., Following a pelvic trauma, a cystogram is ordered to rule out bladder rupture.The radiologist uses code 74430 to interpret the images, determining the presence or absence of contrast extravasation., A patient presents with hematuria (blood in the urine).A cystogram is performed, and the radiologist (using code 74430) interprets the images to evaluate for the presence of bladder tumors or other structural abnormalities.

* Detailed clinical indication for the cystogram.* Report specifying the number of views obtained and reviewed.* Radiologist's interpretation of the images, including findings and conclusions.* Any relevant additional imaging studies.

** Always consult with your payer's specific guidelines and local coverage determinations (LCDs) for reimbursement policies regarding this code.Accurate documentation is critical for proper claim processing.

  • Revenue Code: I1F (STANDARD IMAGING - OTHER)
  • Payment Status: Active
  • Modifier TC rule: Modifier TC (technical component) is applicable when only the technical aspect of the procedure (image acquisition) is performed by a different entity than the interpretation.
  • Specialties:Urology, Radiology
  • Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center
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