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2025 CPT code 74450

Radiological supervision and interpretation of a retrograde urethrocystography.

Follow all relevant CPT coding guidelines and payer-specific instructions. Adherence to local coverage determinations (LCDs) and medical necessity criteria is crucial for accurate reimbursement.

Modifiers -26 (professional component) and -TC (technical component) may be applied as appropriate, depending on the services performed and payer policies.

Medical necessity for a retrograde urethrocystography is established when there is a clinical indication to evaluate the urethra and bladder for abnormalities such as strictures, obstructions, trauma, or other suspected pathology.The ordering physician must document the specific clinical indication in the patient's medical record.

The radiologist's responsibility is to supervise the technical aspects of the retrograde urethrocystography and to interpret the resulting radiographic images to provide a diagnostic report.

IMPORTANT:Code 51610 (Injection procedure for retrograde urethrocystography) is often reported in conjunction with 74450, representing the injection procedure itself.Modifier -26 should be appended to 74450 when billing for professional component only in a hospital or ASC setting.Modifier -TC may be appended when billing only for technical component.Fluoroscopy is considered included in this code and should not be billed separately.

In simple words: The doctor reviews X-ray images of the bladder and urethra after a special dye has been used to make them clearer.This helps to diagnose problems in these areas.

This CPT code encompasses the radiological supervision and interpretation of a retrograde urethrocystography.The procedure involves the retrograde instillation of fluid (contrast material) into the urethra and bladder to visualize these structures radiographically. The radiologist reviews the resulting images to identify and diagnose abnormalities within the bladder and/or lower urinary tract. This code represents both the technical and professional components of the service; however, modifier -26 may be appended if only the professional component is reported, and modifier -TC if only the technical component is reported (payer policies may vary).

Example 1: A patient presents with suspected urethral stricture. A retrograde urethrocystogram is performed, and the radiologist (using code 74450) interprets the images to confirm the diagnosis and determine the extent of the stricture., A patient experiences urinary incontinence. A retrograde urethrocystogram is conducted, and the radiologist uses code 74450 to analyze the images for any anatomical abnormalities contributing to the incontinence, such as bladder diverticula or urethral prolapse., Post-prostatectomy, a patient presents with urinary retention.A retrograde urethrocystography is performed. The radiologist, using code 74450, interprets the images to assess for the presence of urethral obstruction, bladder neck contracture, or other post-operative complications.

* Complete and legible radiographic images.* Detailed clinical history and indication for the procedure.* Radiologist's comprehensive interpretation report including technical details (e.g., type and amount of contrast used), findings, and diagnostic impression.* If performed in a facility, documentation of who performed the injection and technical aspects of the procedure.

** Always refer to the most current CPT codebook and payer-specific guidelines for the most accurate and up-to-date coding information.Understanding of payer policies regarding professional vs. technical components is vital for proper billing.The interpretation report should be thorough and consistent with the standard of care.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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