Wiki CT Cystogram

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How would you code a CT Cystogram? It doesn't seem like you would code 51600 with 74430, since the exam was performed by CT.
I am questioning if 51600 and 72192 should be coded?
72192=Computed tomography, pelvis; without contrast material
51600=
Injection procedure for cystography or voiding urethrocystography
74430=
Cystography, minimum of 3 views, radiological supervision and interpretation
 
"A Cystogram is an examination that takes pictures of your bladder and urethra and is performed by a Radiologist and assisted by an x-ray technologist. Contrast material is introduced into your bladder through the catheter, then x-rays are taken with the contrast material in your bladder."

Actually, you would bill/code for the injection to administer the contrast then the CT scan.
 
"A Cystogram is an examination that takes pictures of your bladder and urethra and is performed by a Radiologist and assisted by an x-ray technologist. Contrast material is introduced into your bladder through the catheter, then x-rays are taken with the contrast material in your bladder."

Actually, you would bill/code for the injection to administer the contrast then the CT scan.
Would you code 51600 and 72192(CT pelvis w/out contrast), since the contrast is given via the cath or 51600 and 72193(CT pelvis w/contrast)?
Our radiology dept is charging 51600 and 72194(CT pelvis w/out followed by contrast).
 
  • First code would be 51600. (A urinary catheter is inserted through the urethra into the bladder and a radiopaque liquid (contrast or contrast agent) is injected. Under the guidance of a fluoroscope the physician observes the filling and voiding once the contrast enters the bladder and finally the reflux when the person voids. If the liquid flows from the bladder into the urethra during voiding, then it's normal. But abnormality is seen if the contrast moves into the ureters and the kidney and it may be diagnosed as vesicoureteral reflux. Finally, the catheter is removed.)
    • You wouldn't code 72194 because that's via IV/injection only. (The provider places the patient in a supine position on the scanner table and inserts an intravenous, or IV line into the patient. He supervises the administration of the IV contrast, scout films or preliminary images, and the actual pelvic image acquisition, first without injecting contrast material and later after administering contrast via an injection for better image quality. The scanner moves around the patient’s body and takes pictures of the pelvis. The images display on the monitor screen. The provider reviews the images, does his analysis, and interprets the results. Finally, the provider prepares a report of his findings.)
  • Second code would be 74430 according to the information you gave me. (In this procedure the provider performs imaging supervision and interpretation for a procedure where the provider inserts a catheter into the urethra up to the bladder and injects contrast material through the catheter into the bladder. Then he removes the catheter and takes X–rays while the bladder is full. After draining of the bladder, the technician takes more X–rays. The radiology provider studies the X–ray images to identify any possible rupture or leakage of the bladder that could show outflow of the contrast material. He takes a minimum of three views in this procedure. He commonly performs this procedure to know the cause of such conditions as infections, tumors, or stones. Report this code to represent only imaging supervision and interpretation for this procedure.)
 
Watch the terminology for how the dye is applied: Instillation = fluid introduced into body cavity. Using "injected" in the definition of the procedure is somewhat confusing.
 
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