CPT® Code 74475

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1. Indications

The procedure associated with CPT® Code 74475 is indicated for specific clinical scenarios where intervention in the renal pelvis is necessary. The following conditions may warrant the performance of this procedure:

• Fluid Accumulation The presence of excess fluid in the kidney, which may require drainage to alleviate pressure or prevent infection.
• Therapeutic Injection The need to inject medications or contrast agents directly into the renal pelvis for diagnostic or therapeutic purposes.

2. Procedure

The procedure for CPT® Code 74475 involves several critical steps to ensure successful catheter placement into the renal pelvis. Each step is essential for achieving the desired outcome while minimizing risks to the patient.

• Step 1: Patient Preparation The patient is positioned appropriately, and the area of the skin where the catheter will be inserted is cleaned and sterilized to reduce the risk of infection. Local anesthesia may be administered to ensure patient comfort during the procedure.
• Step 2: Imaging Guidance The physician utilizes imaging techniques, such as fluoroscopy or ultrasound, to visualize the kidney and surrounding structures. This imaging is crucial for accurately locating the renal pelvis and guiding the catheter placement.
• Step 3: Catheter Insertion A needle is carefully inserted through the skin and advanced into the renal pelvis under imaging guidance. Once the correct position is confirmed, a catheter is threaded through the needle into the renal pelvis.
• Step 4: Drainage or Injection Depending on the indication for the procedure, the physician either drains fluid from the renal pelvis or injects a therapeutic substance. This step is performed while continuously monitoring the position of the catheter using radiological imaging.
• Step 5: Catheter Securing and Post-Procedure Imaging After the procedure is completed, the catheter is secured in place, and additional imaging may be performed to confirm the catheter's position and ensure that the procedure was successful.

3. Post-Procedure

Following the completion of the procedure, the patient is monitored for any immediate complications, such as bleeding or infection. The catheter may remain in place for a specified duration, depending on the clinical indication, and the patient will receive instructions on care and maintenance of the catheter. Follow-up imaging may be scheduled to assess the effectiveness of the drainage or injection and to ensure that the kidney is functioning properly. Patients are also advised to report any unusual symptoms, such as fever or increased pain, to their healthcare provider promptly.