Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Endoscopic catheterization of the pancreatic ductal system is a specialized medical procedure aimed at diagnosing and treating various conditions affecting the pancreatic duct. This procedure is particularly relevant for patients experiencing issues such as pancreatic duct obstruction, dilation, inflammation, the presence of stones, or tumors. The pancreatic duct plays a crucial role in the digestive system as it connects to the common bile duct just before the ampulla of Vater, which is located in the duodenum. This anatomical junction is significant because it is where bile and pancreatic fluid are released into the digestive tract. During the procedure, the patient is typically sedated to ensure comfort. An endoscope, a flexible tube equipped with a camera and light, is inserted orally into the stomach and carefully advanced to the duodenal papilla. To facilitate the procedure, medications such as anti-cholinergics, glucagon, or nitroglycerin may be administered to relax the sphincter of Oddi, allowing easier access to the pancreatic duct. Once the ampulla of Vater is reached, a small catheter is threaded through the endoscope and used to inject contrast dye into the pancreatic ducts. This step is essential for visualizing the pancreatic ductal system through X-ray imaging. The catheter is then advanced over a guidewire into the pancreatic duct, enabling further diagnostic or therapeutic interventions. The procedure is typically performed by a gastroenterologist, often in collaboration with a radiologist, to ensure accurate imaging and interpretation. The CPT® Code 74329 is specifically designated for reporting the radiological supervision and interpretation associated with this endoscopic catheterization procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Endoscopic catheterization of the pancreatic ductal system is indicated for several specific conditions that affect the functionality and health of the pancreatic duct. These indications include:

  • Pancreatic Duct Obstruction - This condition occurs when there is a blockage in the pancreatic duct, which can lead to complications such as pancreatitis or digestive issues.
  • Dilation of the Pancreatic Duct - Dilation may occur due to various factors, including chronic inflammation or obstruction, necessitating intervention to restore normal function.
  • Pancreatic Duct Inflammation - Inflammation can result from conditions such as pancreatitis, and catheterization may be required to assess and manage the underlying issues.
  • Presence of Stones - The formation of stones within the pancreatic duct can obstruct the flow of pancreatic juices, leading to pain and other complications that may require removal.
  • Pancreatic Tumors - Tumors in or around the pancreatic duct can cause obstruction or other issues, making it essential to evaluate and potentially treat these growths.

2. Procedure

The procedure for endoscopic catheterization of the pancreatic ductal system involves several critical steps to ensure successful diagnosis and treatment. The process begins with the patient being sedated to minimize discomfort during the procedure.

  • Step 1: Patient Preparation - The patient is prepared for the procedure, which includes obtaining informed consent and ensuring that they are in a comfortable position. Sedation is administered to help the patient relax.
  • Step 2: Insertion of the Endoscope - An endoscope, a flexible tube equipped with a camera and light, is carefully inserted orally into the patient's mouth and advanced through the esophagus into the stomach, and then further into the duodenum, where the ampulla of Vater is located.
  • Step 3: Administration of Medications - To facilitate easier access to the pancreatic duct, medications such as anti-cholinergics, glucagon, or nitroglycerin may be administered. These medications help relax the sphincter of Oddi, which controls the flow of digestive juices.
  • Step 4: Cannulation of the Ampulla of Vater - Once the endoscope is positioned correctly, the ampulla of Vater is cannulated using a small catheter that is threaded through the endoscope. This step is crucial for accessing the pancreatic duct.
  • Step 5: Injection of Contrast Dye - Contrast dye is injected into the pancreatic ducts through the catheter. This imaging agent allows for clear visualization of the pancreatic ductal system via X-ray imaging, helping to identify any abnormalities.
  • Step 6: Advancement of the Catheter - The catheter is then advanced over a guidewire into the pancreatic duct. This step is essential for further diagnostic evaluation or therapeutic interventions, such as the placement of a stent or drain if necessary.

3. Post-Procedure

After the endoscopic catheterization of the pancreatic ductal system, patients are typically monitored for any immediate complications or adverse reactions to sedation. It is common for patients to experience some discomfort or mild pain in the abdominal area following the procedure. Recovery time may vary, but patients are usually advised to rest and avoid strenuous activities for a short period. Follow-up appointments may be scheduled to discuss the results of the imaging and any further treatment options that may be necessary based on the findings. Additionally, patients may receive specific instructions regarding diet and activity levels as they recover from the procedure.

Short Descr X-RAY FOR PANCREAS ENDOSCOPY
Medium Descr ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I
Long Descr Endoscopic catheterization of the pancreatic ductal system, 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 Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I1D - Standard imaging - contrast gastrointestinal
MUE 1
CCS Clinical Classification 82 - Endoscopic retrograde cannulation of pancreas (ERCP)
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
CR Catastrophe/disaster related
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AM Physician, team member service
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"