Radiology Coding Alert

Question: Is loopography the same as urography? Which codes apply to loopography?

Vermont Subscriber

Answer: Loopography is a type of urography. Specifically, it is a kind of antegrade urography (performed in the normal direction of flow).

For the radiological supervision and interpretation portion of a loopogram, you should report 74425 (Urography, antegrade [pyelostogram, nephrostogram, loopogram], radiological supervision and interpretation).

The radiologist may perform the surgical portion, as well. If so, you also should report 50690 (Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service).

The service: A loopogram is a diagnostic test performed by injecting contrast through a catheter inserted percutaneously into the patient's ileal conduit, which is created in certain patients who have lost normal bladder function. For the conduit, the surgeon uses part of the ileum (terminal end of the small intestine) to build a replacement for the urinary bladder. To function, the ureters must be implanted into the new structure. The conduit opens through the skin of the abdomen to drain urine. The loopogram allows the physician to see whether the ureters are functioning properly.