Summary & Overview
CPT 74415: IV Pyelography with Nephrotomography
CPT code 74415 denotes a contrast‑enhanced radiographic study of the kidneys, ureters, and bladder performed after a rapid intravenous bolus, with nephrotomography. This imaging procedure is used to visualize the urinary collecting systems and bladder anatomy, aiding diagnosis of obstruction, stones, structural anomalies, and other urologic conditions. As a specialized radiology service, it typically occurs in hospital radiology departments or outpatient imaging centers where IV contrast and tomographic radiography are available.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on clinical context, coding definitions, and payer coverage considerations for this procedure.
Readers will find concise benchmarks and operational context for CPT code 74415, including typical sites of service, clinical indications that prompt use of the study, and high‑level policy considerations affecting coverage and billing. Where payer‑specific payment rates or contractual details are required, note that those items vary by plan and provider contract. Data not available in the input will be identified as such in relevant sections.
Billing Code Overview
CPT code 74415 describes an X‑ray examination of the kidneys, ureters, and bladder performed after a rapid bolus intravenous injection, completed with nephrotomography. This procedure is an imaging study of the urinary tract that uses contrast material administered intravenously to opacify the renal collecting systems and bladder, followed by tomographic radiographic imaging to evaluate anatomy and potential abnormalities.
Service type: Contrast-enhanced radiographic imaging of the urinary tract with nephrotomography
Typical site of service: Hospital radiology department or freestanding outpatient imaging center, where intravenous contrast administration and tomographic radiography are performed under radiology supervision.
Clinical & Coding Specifications
Clinical Context
A 58-year-old outpatient with acute flank pain and hematuria presents to the radiology department for an intravenous pyelogram (IVP) with nephrotomography. The ordering urologist requests contrast-enhanced radiographic imaging to evaluate suspected ureteral obstruction from a ureteral stone and to assess renal collecting system anatomy. The patient arrives after renal function assessment and allergy screening; the radiology technologist obtains IV access and performs rapid bolus injection of iodinated contrast while the radiologist times and acquires serial radiographs. Nephrotomography (tomographic radiographs through the kidney) is performed to improve visualization of intrarenal and perirenal structures. Images are reviewed by the interpreting radiologist, a procedure report is finalized, and images are delivered to the urology service for further management. Typical site of service is an outpatient radiology suite, hospital radiology department, or ambulatory surgical center depending on clinical setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpreting physician’s service separate from technical component. |
TC | Technical component |