Summary & Overview
CPT 74410: Intravenous Pyelogram (Kidneys, Ureters, Bladder)
CPT code 74410 designates an intravenous pyelogram (IVP) — an X-ray examination of the kidneys, ureters, and bladder performed after intravenous administration of contrast. This diagnostic radiology code matters nationally because it is used to image urinary tract anatomy and detect obstruction, stones, or structural abnormalities; appropriate coding affects claims processing, clinical documentation, and utilization monitoring across hospitals and outpatient imaging centers. Key payers typically engaged in national reimbursement and coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context for using 74410, the typical sites where the service is delivered, and which payers are relevant for national policy and coverage patterns. The publication includes benchmarks and payer-focused considerations, summaries of common modifiers and billing practice notes, and a concise clinical overview linking the procedure to common indications. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 74410 describes an X-ray examination of the kidneys, ureters, and bladder performed after administration of an intravascular contrast agent via intravenous drip or rapid bolus injection. The procedure captures radiographic images to evaluate urinary tract anatomy and function following contrast administration.
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Service type: Diagnostic radiology procedure involving contrast-enhanced imaging of the urinary tract
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Typical site of service: Hospital radiology department or outpatient imaging center
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to the radiology department with flank pain, hematuria, and a history of recurrent urinary tract infections. The ordering clinician requests a contrast-enhanced radiographic evaluation of the urinary collecting system to assess renal function, opacification of the ureters, and bladder filling. The procedure is scheduled in an outpatient imaging center or hospital radiology suite equipped for intravenous contrast administration and fluoroscopic imaging.
The workflow begins with verification of the patient identity, review of allergies (especially to iodinated contrast), assessment of renal function (serum creatinine/eGFR), and informed consent. An intravenous catheter is placed, and iodinated contrast is administered via a controlled drip or rapid bolus. Fluoroscopic spot images and timed radiographs are obtained to visualize renal cortical blush, excretion through the ureters, and bladder filling. Post-procedure monitoring includes observation for adverse contrast reactions and provision of post-study instructions. Images are interpreted by a radiologist, with a formal report documented in the electronic health record and forwarded to the referring clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Used when only the interpreting physician's professional component is billed separate from technical services. |