Summary & Overview
CPT 74425: Antegrade Urography Imaging Supervision and Interpretation
CPT code 74425 represents imaging supervision and interpretation for an antegrade urography examination, a diagnostic radiology procedure in which contrast is injected in the direction of normal urinary flow and radiographs are obtained. This code is used when a provider performs the supervisory and interpretive components of antegrade contrast studies, commonly employed to evaluate urinary tract anatomy or obstruction when retrograde access is not feasible. Nationally, accurate coding of this procedure affects clinical documentation, imaging utilization metrics, and appropriate payment for fluoroscopically guided urinary tract studies.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on billing and clinical context rather than state-specific rules.
Readers will learn what CPT code 74425 denotes, the clinical circumstances that typically prompt antegrade urography, and where the service is commonly delivered. The report summarizes benchmark considerations and common coding and documentation elements relevant to supervision and interpretation of antegrade contrast studies. Where input data is incomplete for specific payers, modifiers, or diagnosis mappings, the document notes that those details are not available in the input.
Billing Code Overview
CPT code 74425 describes imaging supervision and interpretation for an antegrade urography examination in which contrast is injected in the direction of normal urinary flow and radiographs are obtained. This procedure involves guiding contrast from a percutaneous or other antegrade access toward the bladder to evaluate the urinary tract.
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Service type: Imaging supervision and interpretation for diagnostic radiologic contrast study (antegrade urography)
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Typical site of service: Hospital radiology department or outpatient imaging center where fluoroscopic guidance and radiography are performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a history of recurrent nephrolithiasis presents with flank pain and hematuria. Non-contrast CT suggests obstructing calculi in the proximal ureter and impaired antegrade flow of urine from the affected kidney. The urology team schedules an antegrade pyelography (antegrade urography) to evaluate the collecting system anatomy, confirm level of obstruction, and guide possible percutaneous nephrostomy or stent placement. The patient is transported to the radiology/interventional suite. Under sterile technique, a percutaneous renal access is obtained and contrast is injected in the direction of normal urinary flow while the radiologist supervises imaging acquisition and performs interpretation. Fluoroscopic images and radiographs are obtained to document contrast opacification of the renal pelvis, calyces, ureter, and bladder. Findings are communicated to the urology team, and the report documents technique, volumes and type of contrast used, any complications, and interpretation. Typical site of service: hospital radiology or interventional radiology suite, or outpatient ambulatory surgical center when percutaneous access is performed electively. Service type: imaging supervision and interpretation for antegrade urography with contrast injection in the direction of normal urinary flow.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's professional service separate from technical component. |