CPT® Code 74400

The procedure described by CPT® Code 74400 refers to intravenous urography, also known as pyelography. This imaging technique is utilized to visualize and examine the urinary tract, which includes the kidneys, ureters, bladder, and urethra. The process involves the injection of a contrast agent into a vein, which enhances the visibility of these structures on imaging studies. The primary purpose of this procedure is to assess the normal functioning of the urinary system, identify any anatomical variations or congenital anomalies, and detect the presence of obstructions or tumors within the urinary tract. During the procedure, intravenous access is established to facilitate the injection of the contrast material. Initial scout films, which are preliminary images of the kidneys, ureters, and bladder (often referred to as KUB), may be taken to provide a baseline for comparison. Following the injection of the contrast, fluoroscopic imaging is performed at various intervals while the patient is positioned in different orientations, such as supine, prone, or oblique, to capture comprehensive views of the urinary system. If tomography is included in the procedure, it allows for the imaging of the urinary system in sections, creating a three-dimensional representation that enhances the detail and clarity of the images obtained. As the contrast material filters through the kidneys and travels down the ureters to accumulate in the bladder, the patient may be asked to void. Additional films may then be taken to evaluate the function of the urethra, ensuring that the bladder is completely emptied. This thorough approach provides valuable diagnostic information regarding the urinary tract's structure and function.