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Official Description

Urethrocystography, voiding, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 74455 refers to a specific radiological procedure known as voiding urethrocystography, which involves the examination of the urethra and bladder using fluoroscopy in conjunction with a radiopaque contrast medium. This procedure is essential for visualizing the urinary tract and is particularly useful in diagnosing various conditions that may affect the urethra and bladder. During the procedure, a contrast agent is introduced through the external urethral orifice, which serves to distend and fill both the urethra and bladder, allowing for enhanced imaging. The use of fluoroscopy enables real-time visualization, which is critical for assessing the anatomy and function of these structures. The indications for performing voiding urethrocystography include the evaluation of potential injuries, congenital anomalies, tumors, diverticula, stones, fistulas, strictures, or any obstructions that may be present within the urinary tract. The procedure involves obtaining X-ray images of the urethra and bladder from multiple angles to ensure comprehensive assessment. Following the initial imaging, the patient is asked to void while additional X-rays are taken to observe the flow of the contrast medium as it exits the bladder and passes through the urethra. This dynamic assessment is crucial for identifying any abnormalities in the urinary system. The CPT® Code 74455 encompasses not only the technical aspects of the procedure but also the radiological supervision, review of the obtained records, and the interpretation of the findings, culminating in a written report that documents the results of the examination.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The voiding urethrocystography procedure, represented by CPT® Code 74455, is indicated for a variety of clinical scenarios. The following conditions may warrant the performance of this procedure:

  • Injury - Assessment of potential trauma to the urethra or bladder.
  • Congenital Anomalies - Evaluation of any birth defects affecting the urinary tract.
  • Tumors - Identification and characterization of neoplastic growths within the urethra or bladder.
  • Diverticula - Detection of abnormal pouches that may form in the bladder wall.
  • Stones - Visualization of calculi that may obstruct the urinary tract.
  • Fistulas - Investigation of abnormal connections between the urinary tract and other structures.
  • Strictures - Assessment of narrowing within the urethra that may impede urine flow.
  • Obstruction - Evaluation of any blockages that may affect urinary function.

2. Procedure

The voiding urethrocystography procedure involves several critical steps to ensure accurate imaging and assessment of the urinary tract. The following procedural steps are performed:

  • Step 1: Preparation - The patient is positioned appropriately for the procedure, typically lying on an examination table. The area around the external urethral orifice is cleaned to minimize the risk of infection.
  • Step 2: Contrast Instillation - A radiopaque contrast medium is carefully instilled through the external urethral orifice. This process distends the urethra and bladder, allowing for clear visualization during imaging.
  • Step 3: Initial Imaging - X-ray images are obtained from one or more angles to capture the anatomy of the urethra and bladder while the contrast medium is present. This initial imaging is crucial for identifying any structural abnormalities.
  • Step 4: Voiding Phase - The patient is instructed to void while additional X-rays are taken. This phase allows for the observation of the flow of contrast as it exits the bladder and passes through the urethra, providing valuable information about urinary function and potential obstructions.
  • Step 5: Post-Procedure Imaging - Further X-ray images may be obtained to ensure that all contrast has been expelled and to assess the urinary tract's response during the voiding process.

3. Post-Procedure

After the completion of the voiding urethrocystography, the patient may be monitored briefly to ensure there are no immediate complications. It is common for patients to experience mild discomfort or a sensation of urgency following the procedure, but these symptoms typically resolve quickly. The radiologist will review the images obtained during the procedure and provide a comprehensive interpretation of the findings. A written report will be generated, detailing the results and any identified abnormalities, which will be shared with the referring physician for further evaluation and management. Patients are usually advised to drink plenty of fluids post-procedure to help flush out the contrast medium from their system.

Short Descr X-RAY URETHRA/BLADDER
Medium Descr URETHROCYSTOGRAPHY VOIDING RS&I
Long Descr Urethrocystography, voiding, 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.
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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).
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
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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
FS Split (or shared) evaluation and management visit
FX X-ray taken using film
GA Waiver of liability statement issued as required by payer policy, individual case
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
GZ Item or service expected to be denied as not reasonable and necessary
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
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
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
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.
Pre-1990 Added Code added.
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