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CPT® Code 74430 refers to a diagnostic imaging procedure known as cystography, which involves the use of fluoroscopy and a radiopaque contrast medium to examine the bladder. This procedure is essential for visualizing the bladder's structure and function, particularly in diagnosing various conditions. The term "radiological supervision" indicates that a qualified radiologist oversees the procedure, ensuring that it is performed correctly and safely. Cystography is particularly useful in identifying issues such as vesicoureteral reflux, which is the abnormal flow of urine from the bladder back into the ureters; bladder tumors, which are abnormal growths that can indicate cancer; polyps, which are growths that can develop on the bladder wall; and injuries to the bladder that may result from trauma or other medical conditions. Before the cystography begins, an X-ray of the bladder or urinary tract may be performed without contrast to provide a baseline image. During the procedure, a catheter is carefully inserted through the urethra into the bladder, allowing for the instillation of the contrast medium. This contrast is introduced until the bladder is adequately distended, enabling clear imaging. Multiple X-rays are then taken from various angles to capture detailed views of the bladder and ureters. After the imaging is completed, the catheter is removed, and the patient is allowed to void. An additional X-ray is taken post-voiding to confirm that all contrast material has been expelled from the bladder. The comprehensive nature of this procedure is encapsulated in CPT® Code 74430, which includes the radiological supervision, a minimum of three views, the review of records, interpretation of the findings, and the generation of a written report detailing the results of the cystography.
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The procedure of cystography, as described by CPT® Code 74430, is indicated for several specific conditions and diagnostic purposes. These include:
The cystography procedure, as outlined in CPT® Code 74430, involves several critical steps to ensure accurate imaging of the bladder. The process begins with the patient being positioned appropriately for the imaging study. Following this, a catheter is inserted through the urethra into the bladder. This step is crucial as it allows for the introduction of a radiopaque contrast medium, which is essential for visualizing the bladder during the imaging process. Once the catheter is in place, the contrast medium is instilled into the bladder until it is adequately distended. This distension is necessary to provide clear images of the bladder's interior and its relationship with the ureters. After the bladder is filled with contrast, a series of X-rays are taken from a minimum of three different views. These multiple angles are important for obtaining comprehensive images that can reveal any abnormalities or conditions affecting the bladder and ureters. Once the imaging is complete, the catheter is carefully removed, and the patient is allowed to void. This step is significant as it helps to assess the bladder's ability to expel the contrast medium. Following the voiding, an additional X-ray is obtained to ensure that all contrast has been expelled from the bladder, providing further confirmation of the bladder's function and integrity.
After the cystography procedure is completed, patients may be monitored briefly to ensure there are no immediate complications from the catheter insertion or the contrast medium used. It is common for patients to experience mild discomfort or a sensation of urgency to void following the procedure. Patients are typically advised to drink plenty of fluids to help flush out the contrast material from their system. Additionally, they may be informed about potential side effects, such as temporary changes in urination or mild abdominal discomfort. A written report detailing the findings from the cystography will be generated by the radiologist, which will include the interpretation of the images and any recommendations for further evaluation or treatment if necessary.
| Short Descr | CONTRAST X-RAY BLADDER | Medium Descr | CYSTOGRAPHY MINIMUM 3 VIEWS RS&I | Long Descr | Cystography, minimum of 3 views, radiological supervision and interpretation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1F - Standard imaging - other | MUE | 1 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | GC | This service has been performed in part by a resident under the direction of a teaching physician | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | FX | X-ray taken using film | FY | X-ray taken using computed radiography technology/cassette-based imaging | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 2008-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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