Summary & Overview
CPT 74329: Imaging Supervision for Endoscopic Pancreatic Duct Fluoroscopy
CPT code 74329 denotes the imaging supervision and interpretation component of an endoscopic pancreatic duct catheterization with fluoroscopic contrast imaging. The code is applicable when a provider oversees and interprets X‑ray fluoroscopic studies performed during insertion of an endoscope and catheter into the pancreatic ducts to evaluate for tumors, strictures, stones, or other ductal pathology. Nationally, this code matters because it separates the professional imaging interpretation from the separately reportable endoscopic procedure, affecting documentation, billing lineage, and payer adjudication.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical and procedural context for 74329, an overview of typical sites of service (hospital outpatient departments and ambulatory surgery centers), and guidance on where this code fits in professional versus technical billing. The publication outlines common modifiers associated with imaging interpretation billing and highlights policy considerations around reporting only the imaging supervision and interpretation when the endoscopic procedure is billed separately.
This resource is intended for national audiences involved in coding, revenue cycle, and clinical administration who need a clear reference on how CPT code 74329 is used and documented in the care of patients undergoing endoscopic pancreatic duct evaluation.
Billing Code Overview
CPT code 74329 represents imaging supervision and interpretation for an endoscopic pancreatic duct catheterization performed with fluoroscopic imaging. In this procedure the provider supervises and interprets X‑ray imaging while a camera (endoscope) and catheter are inserted into the pancreatic ducts, contrast is administered, and fluoroscopic images are obtained to evaluate for tumors, strictures, stones, or other ductal abnormalities.
Service type: Imaging supervision and interpretation for endoscopic pancreatic duct catheterization
Typical site of service: Hospital outpatient department or ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with recurrent epigastric pain, unexplained weight loss, and abnormal liver function tests is referred for evaluation of possible pancreatobiliary disease. Prior noninvasive imaging (abdominal ultrasound and CT) suggested dilatation of the pancreatic duct. The gastroenterologist schedules an endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic duct catheterization to visualize the ductal anatomy and identify strictures, stones, or tumors. During the procedure an endoscope is advanced to the duodenum and a catheter is cannulated into the pancreatic duct. Contrast is injected and real-time fluoroscopic imaging is performed.
In this scenario the interpreting physician bills 74329 to report only the imaging supervision and interpretation component of the endoscopic pancreatic duct catheterization. The typical workflow involves pre-procedure review of indications and prior imaging, supervision of fluoroscopic contrast injection and image acquisition in the endoscopy suite or catheterization lab, and generation of a formal fluoroscopic interpretation report documenting ductal filling defects, strictures, leaks, or other findings. Post-procedure recommendations and communication of critical results to the performing endoscopist and care team are part of the interpretation service.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |