CPT® Code 74290

1. Indications

Cholecystography with oral contrast is indicated for the evaluation of various conditions related to the gallbladder and biliary system. The following are the specific indications for this procedure:

• Gallstones The procedure is performed to detect the presence of gallstones, which can cause pain and complications if they obstruct the bile ducts.
• Gallbladder tumors Cholecystography can help identify abnormal growths or tumors within the gallbladder that may require further investigation or intervention.
• Polyps The examination can reveal the presence of polyps, which are growths on the gallbladder wall that may need monitoring or removal.
• Inflammation The procedure is useful in assessing inflammation of the gallbladder, known as cholecystitis, which can result from gallstones or other factors.
• Infection Cholecystography can help identify infections in the gallbladder or biliary tract, which may necessitate treatment.
• Dysfunction The procedure may be indicated to evaluate gallbladder dysfunction, which can affect bile release and digestion.

2. Procedure

The cholecystography procedure involves several key steps to ensure accurate imaging and assessment of the gallbladder. The following outlines the procedural steps:

• Step 1: Patient Preparation Prior to the procedure, the patient is instructed to fast for a specified period, typically overnight, to ensure that the gallbladder is adequately filled with bile. This fasting period is crucial for optimal imaging results.
• Step 2: Administration of Oral Contrast A contrast dye is administered orally to the patient. This contrast agent is designed to be absorbed by the gastrointestinal tract and subsequently excreted by the liver into the gallbladder, enhancing its visibility on X-ray images.
• Step 3: Imaging Acquisition After a waiting period to allow for the absorption and excretion of the contrast, the patient is positioned supine on the examination table. Fluoroscopic imaging is then performed, capturing real-time images of the gallbladder as the contrast fills the organ.
• Step 4: Interval Imaging Radiographic films are taken at specific intervals during the procedure to document the appearance of the gallbladder and any potential abnormalities. This step is critical for identifying gallstones, tumors, and other conditions.
• Step 5: Stimulation of Bile Release During the imaging process, the patient may be given a special liquid to drink, which stimulates the gallbladder to contract and release bile. This action can provide additional information about gallbladder function and the presence of any obstructions.

3. Post-Procedure

After the cholecystography procedure, the patient may be monitored for a short period to ensure there are no immediate adverse reactions to the contrast dye. It is common for patients to resume normal activities shortly after the procedure, although they may be advised to hydrate adequately to help flush the contrast agent from their system. Any specific post-procedure instructions, such as dietary recommendations or follow-up appointments, should be provided by the healthcare professional based on the individual patient's needs and findings from the imaging study.