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The peritoneogram, identified by CPT® Code 74190, is a specialized radiological procedure designed to visualize the contours and external surfaces of the abdominal viscera and peritoneum. This imaging technique is particularly useful for measuring the wall thickness of various portions of the digestive organs and for detecting the presence and extent of extra-abdominal tumors or diseases. The procedure involves the careful selection of an appropriate site in the abdominal area, where local anesthesia is administered to infiltrate the skin and subcutaneous tissue down to the level of the peritoneum. Utilizing fluoroscopy, which provides real-time X-ray guidance, a needle is inserted into the peritoneum, and a flexible catheter is subsequently threaded into place. Once the catheter is positioned, contrast dye and/or air are injected into the peritoneal space, allowing for enhanced visualization during the imaging process. Additional X-rays are then obtained with the patient in various positions to capture comprehensive images of the abdominal area. At the conclusion of the procedure, the catheter is removed. The CPT® Code 74190 specifically denotes the radiologist's role in supervising the procedure and interpreting the resulting findings, ensuring accurate documentation and reporting of the imaging performed.
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The peritoneogram is indicated for various clinical scenarios where detailed visualization of the abdominal cavity is necessary. The following conditions may warrant the performance of this procedure:
The peritoneogram procedure involves several critical steps to ensure accurate imaging and patient safety. The following outlines the procedural steps:
After the completion of the peritoneogram, patients may be monitored for any immediate adverse reactions to the contrast material used. It is essential to provide post-procedure care instructions, which may include advising the patient to report any unusual symptoms such as abdominal pain or discomfort. Recovery time may vary, but patients are generally able to resume normal activities shortly after the procedure, depending on their overall health and any specific instructions given by the healthcare provider. Follow-up imaging or assessments may be scheduled based on the findings from the peritoneogram to ensure comprehensive evaluation and management of any identified conditions.
| Short Descr | PERITONEOGRAM RS&I | Medium Descr | PERITONEOGRAM RS&I | Long Descr | Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 1 | CCS Clinical Classification | 226 - Other diagnostic radiology and related techniques |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2025-01-01 | Changed | Short Description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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