Summary & Overview
CPT 74775: Imaging of Female Perineum for Sex or Deformity Assessment
CPT code 74775 covers diagnostic imaging of the female perineum to determine sex or to assess the presence and extent of deformity in the reproductive tract. The code captures a focused anatomic evaluation used in clinical scenarios such as ambiguous genitalia assessment, post-traumatic evaluation, or preoperative planning for corrective procedures. Nationally, accurate coding for this service supports clinical documentation, appropriate care coordination, and claims processing for sensitive, specialized evaluations.
Key payers in the scope of this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 74775, typical sites of service, and the service type. The report outlines billing and coding considerations, common modifiers encountered with this service line, and where this imaging fits within diagnostic workflows. The publication also highlights benchmarking and policy considerations relevant to organizations and revenue cycle teams, and points to areas where payers commonly apply coverage rules or require additional clinical documentation.
This summary is written for a national audience and provides the operational and clinical context needed to understand CPT code 74775 and its role in reproductive tract imaging.
Billing Code Overview
CPT code 74775 describes imaging of the female perineum performed to determine sex or to evaluate the extent of any deformity of the reproductive tract. This service is a diagnostic imaging procedure focused on external and perineal anatomy to assess congenital or acquired abnormalities affecting the genitalia and perineal structures.
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Service type: Diagnostic imaging focused on perineal examination
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Typical site of service: Outpatient imaging suites, specialty clinics (gynecology/urology), hospital outpatient departments
Clinical & Coding Specifications
Clinical Context
A pediatric endocrinology clinic evaluates an infant with ambiguous external genitalia referred from a newborn nursery. The patient is a newborn assigned female at birth with atypical perineal anatomy noted on physical exam. The clinical team performs a focused perineal imaging assessment to determine the anatomic sex characteristics and the extent of any genital deformity prior to additional laboratory testing and multidisciplinary discussion. The workflow includes brief history and physical, informed consent from the parent or guardian, positioning for external perineal photography and magnified visualization, documentation of external genital anatomy (clitoral size, labial fusion, urethral and vaginal openings), and transmission of images to the multidisciplinary team (pediatric endocrinology, pediatric urology, genetics) for diagnostic and management planning. The procedure is typically performed in an outpatient clinic exam room or a newborn nursery/birthing center under standard newborn care conditions, requiring minimal preparation and no sedation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure | When this perineal imaging is the principal service on the claim |
22 | Increased procedural services |