Cystography/Cystogram CPT Codes

Cystography is performed to study the lower urinary tract. It is used to evaluate different conditions like hydronephrosis, hematuria, bladder cancer, vesicoureteral reflux and bladder polyps. Using a urinary catheter, radiocontrast is instilled in the bladder, and X-ray imaging is performed.

Cystography can be used to evaluate bladder cancer, vesicoureteral reflux, bladder polyps, and hydronephrosis. In adult cases, the patient is typically instructed to void three times, after which a post voiding image is obtained to see how much urine is left within the bladder (residual urine), which is useful to evaluate bladder contraction dysfunction. A final radiograph of the kidneys after the procedure is finished is performed to evaluate for occult vesicoureteral reflux that was not seen during the procedure itself.

In cystography, physician inserts a catheter in bladder and injects contrast medium to study urinary bladder. The images of the normal bladder as well as images during filling, voiding and post-voiding are also obtained. The flow of contrast helps in evaluating function of bladder. When the bladder is filled and then emptied, the function of bladder and lower urinary tract can be accessed.

Cystography/Cystogram CPT Codes

Like all other cases, Cpt code for cystography in medical coding is important as well as a bit complex. For non-voiding and voiding cystography, there are different CPT codes. Here you can find relevant code for different types of cystography with little detail.

Voiding Cystogram

Here are different codes for voiding cystogram.

• This exam is performed when the bladder is fully empty. In this type, the catheter is first inserted through the urethra into the bladder and then contrast medium is injected till it fills the bladder under fluoroscopy. Images can be obtained if there is any reflux of contrast medium present. Once voiding commences, catheter is removed and during voiding and post voiding images are obtained. This CPT code is used with surgical procedure cpt 51600. Cpt 74455 is used as supervision and interpretation code for cpt 51600.
• A radiologic exam to diagnose stricture, obstruction and/or postoperative function of bladder. It is performed mostly on males. A balloon catheter is inserted in retrograde direction against the normal flow of urine in the urethra. Balloon is inflated and contrast medium is injected with the help of fluoroscopy. Images are obtained as the contrast flow against the normal flow in retrograde direction through the urethra and into the bladder. The bladder is drained and more images are obtained. This cpt 74450 is coded with main surgical procedure 51610 as supervision and interpretation.
• A radiographic exam of bladder using contrast material. Minimum three views are taken during this exam. The catheter is inserted directly in the bladder and contrast is injected. Once the bladder is full, it is drained and more images are obtained. This code is used with surgical procedure CPT Code 51600.  Cpt Code 74430 is used as supervision and interpretation for 51600.

Radionuclide Cystogram

A medical test that is performed in order to identify the efficiency of the bladder when it comes to factors like emptying as well as filling up, is known as radionuclide cystogram. A radionuclide cystogram procedure may be performed also for checking for urine reflux as well as any obstruction in the urine flow. This test is performed by inserting catheter urethra opening and guided into the bladder.The catheter is used to fill the bladder up with a radioisotope solution.

Unlike most other cystograms, the radionuclide cystogram may need to be specifically timed according the suspected problem. Scans are usually  taken to identify the presence of incontinence immediately after you empty your bladder.

Retrograde Cystogram

A medical test that is performed in order to identify the efficiency of the bladder when it comes to factors like emptying as well as filling up, is known as radionuclide cystogram. A radionuclide cystogram procedure may be performed also for checking for urine reflux as well as any obstruction in the urine flow. This test is performed by inserting catheter urethra opening and guided into the bladder.The catheter is used to fill the bladder up with a radioisotope solution.

Unlike most other cystograms, the radionuclide cystogram may need to be specifically timed according the suspected problem. Scans are usually  taken to identify the presence of incontinence immediately after you empty your bladder. Retrograde Cystogram

The proper code for the surgical portion is Code 51610 (Injection procedure for retrograde urethrocystography), which includes injection of contrast material into the urethral meatus in a retrograde fashion to delineate the whole urethra and bladder radiologically.

Nuclear Cystogram

78700 through 78740,  this code range covers a several methods for obtaining diagnostic information about the kidneys and collecting system. Definitions of these CPT codes are quite simple.

• A nuclear medicine study is used to  measure urinary bladder residual and this process is coded with 78730. It is usually performed to assess how well the bladder empties, and to detect the presence of any obstruction or dysfunction.
• The detection of vesicoureteral reflux, utilizing imaging during radionuclide filling and emptying of the urinary bladder is reported by code 78740.

Xray Cystogram

Xray cystography includes minimum of three views radiological supervision and interpretation. The imaging portion of the procedure is reported with 74430. The radiologist usually wants films after the bladder has completely emptied because the residual volume may provide valuable information. 

Due to this reason, many images may obtained but it doesn’t matter how many images, they were, 74430 is reported only once. Delayed films are considered part of the procedure and may not be reported separately.Along with the imaging code,  radiologists who perform the injection of contrast media may also report that service with one of two codes:

• 51600 injection procedure for cystography or voiding urethrocystography. CPT 51600  is a starred procedure which means services include only the surgical procedure.
• 51605 injection procedure and placement of chain for contrast and/or chain urethrocystography.  Routine follow-up care