CPT® Code 74480

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1. Indications

The procedure associated with CPT® Code 74480 is indicated for several specific clinical scenarios where intervention is necessary to manage urinary flow or deliver therapeutic agents. The following conditions may warrant the performance of this procedure:

• Ureteral Obstruction The presence of a blockage in the ureter that prevents normal urine flow from the kidney to the bladder, which may be due to stones, tumors, or strictures.
• Urinary Tract Infections Recurrent or severe infections that may require drainage to alleviate symptoms and prevent further complications.
• Hydronephrosis A condition characterized by the swelling of a kidney due to a build-up of urine, often resulting from an obstruction in the ureter.
• Therapeutic Injection The need to administer medications directly into the ureter for conditions such as ureteral strictures or to facilitate the passage of stones.

2. Procedure

The procedure for CPT® Code 74480 involves several critical steps to ensure successful catheter or stent placement within the ureter. 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 insertion is cleaned and sterilized to reduce the risk of infection. Sedation or local anesthesia may be administered to ensure patient comfort during the procedure.
• Step 2: Accessing the Renal Pelvis A percutaneous approach is utilized, where a needle is inserted through the skin into the renal pelvis. This step may involve the use of imaging guidance, such as ultrasound or fluoroscopy, to accurately locate the renal pelvis and ensure proper needle placement.
• Step 3: Catheter or Stent Insertion Once access to the renal pelvis is established, a guide wire is typically introduced through the needle. The ureteral catheter or stent is then threaded over the guide wire and advanced into the ureter. The physician monitors the placement using radiological imaging to confirm correct positioning.
• Step 4: Confirmation and Adjustment After the catheter or stent is in place, additional imaging may be performed to verify that it is correctly positioned and functioning as intended. Adjustments can be made if necessary to ensure optimal drainage or therapeutic delivery.
• Step 5: Securing the Device The catheter or stent is secured in place, and the insertion site is dressed appropriately. The physician may provide instructions for post-procedure care and monitoring.

3. Post-Procedure

Following the procedure associated with CPT® Code 74480, patients are typically monitored for any immediate complications, such as bleeding or infection. Instructions for post-procedure care may include guidelines on activity restrictions, signs of complications to watch for, and follow-up appointments for imaging or evaluation of the catheter or stent's effectiveness. Patients may also be advised on hydration and any medications that may be necessary to manage discomfort or prevent infection. The expected recovery time can vary based on individual patient factors and the complexity of the procedure, but many patients can resume normal activities within a short period, depending on their overall health and the specifics of the intervention.