pyelography

DEFINITION of pyelography

pyelography is radiographic imaging of the renal pelvis, ureters, and urinary tract using injected contrast dye. pyelography encompasses techniques to opacify the upper urinary tract (renal pelvis, calyces, ureters) for fluoroscopic/radiographic assessment of anatomy, function, obstructions, stones, or tumors; primary types include intravenous pyelogram (IVP: systemic contrast excretion), retrograde pyelogram (cystoscopic ureteral catheter injection), and antegrade pyelogram (percutaneous nephrostomy injection).

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ETYMOLOGY of pyelography

greek • Pyelo-: Greek pyelos (πυελός) = “basin, trough” (renal pelvis). • -graphy: Greek graphḗ = “writing, recording.” • Literal: “Basin imaging” (coined early 20th century with iodinated contrast).

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DERIVATIONS of pyelography

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Types and CPT Codes

Type	Method/Details	CPT Code(s)
IVP/IVU	IV contrast → renal filtration/excretion (KUB timed series).[1][2]	74400 (IVP), 74150 (CT urogram modern equiv).
Retrograde	Cystoscopic ureteral catheter injection (no renal function).[7][8]	52351 (w/ureteroscopy), 52005 (diagnostic).
Antegrade	Percutaneous nephrostomy contrast injection.[5]	50434 (fluoroscopy).

ICD-10-PCS: BT1D0ZZ - Fluoroscopy urinary system.[9]

Procedure Details

IVP Protocol:[1][2][4]

1. Scout KUB (pre-contrast).
2. IV iodinated contrast (1-2 mL/kg).
3. Nephrogram (1-5 min), pyelogram (5-15 min), ureter/bladder views.
4. Compression/release films; post-void.

Indications: Hematuria, flank pain, stones (N20.0), obstruction (N13.8), congenital anomalies.[3]

Related Terms

• Urography: Broader (kidney-bladder); IVU = IV pyelogram.
• Nephrogram: Kidney parenchyma phase.
• Cystogram: Bladder-only (VCUG 51600 CPT).
• CT Urogram: Modern replacement (higher sensitivity).[2]

Complications: Contrast nephropathy (rare, hydrate), allergy (1%), UTI (retrograde).[4]

Obsolescence Note: IVP largely replaced by CT urogram (74178 CPT) for superior stone/tumor detection.[2]

One-Sentence Summary
Pyelography (Greek pyelo--graphy “pelvis imaging,” CPT 74400 IVP), opacifies renal pelvis/ureters via IV/retrograde/antegrade contrast for stones (N20.0), obstruction, or hematuria, with IVP protocol capturing nephrogram/pyelogram phases.[7][1][2][4]

Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms