Learn Upper Gastrointentinal CPT Codes with sample charts

Upper gastrointentinal cpt codes with sample charts
Barium swallow(Photo credit: Wikipedia)
Upper GI codes start with 74240 and end with 74249. The only difference between these codes is with single contrast or double contrast. And once we filter these codes, then it’s easy to find out the cpt code on the basis of whether it is done with or without KUB images.
Also there is code for Small Bowel Follow Through, which can be done with single as well as double contrast. So while coding Small Bowel Follow Through with single contrast one has to code 74245 if done along with Upper GI or 74250 if not included upper GI. These tips are really important for Certification exams like CPC, you can go through sample CPC questions here which will surely help in clearing CPC exam.
Small bowel follow through (SBFT) is a exam in which contrast media or barium follows through the small intestines. It is mainly done to diagnose conditions like Crohn’s disease, ulcerative colitis and bowel cancer.
Now, for double contrast one has to check whether they have mention directly double contrast or sometime they will mention Air contrast which also qualifies for double contrast. Also sometimes they will mention effervescence which can be consider as double contrast.
For, single contrast they will directly mention as single contrast.
Also there are other codes which are more or less comes in same category.
74270-74280-The radiology exam of the large intestine carried out after the administration of barium enema to instill contrast into the colon.
Here also one has to differentiate between these codes on the basis of single or double contrast.
74270 - This cpt is coded when the Barium enema exam is performed with single contrast.
74280 – This cpt is coded when the Barium enema exam is performed with double or Air contrast.

74220-74230- Radiologic examination of esophagus or esophagram, in this exam films are taken of the esophagus, before and after the administration of contrast material consisting of barium sulfate. Hence, this exam is commonly known as “Barium Swallow”. It is mainly done to diagnose disorders of esophagus.
74220- Is normal barium swallow exam.
74230- Is modified barium swallow exam. In this exam, films are recorded in a videotape.

Below example will help you how to code Modified barium swallow.

Exam: MODIFIED BARIUM SWALLOW STUDY
INDICATION/DIAGNOSIS: dysphagia
TECHNIQUE: Lateral video fluoroscopy was provided during modified
barium swallow
, performed in conjunction with Speech Pathology. The
patient ingested barium containing food items of varying
consistencies.

FINDINGS:
Mouth-tongue coordination: Normal.
Tongue-palate Competence: Premature spillage of bolus to vallecula
occasionally
Palate-pharyngeal coordination: Normal and no nasal regurgitation was
observed.
Pharyngeal Constriction: No pooling of contrast was observed.
Epiglottis/Larynx Closure: Flash penetration of airway with nectar
consistency but not with other consistencies. This was not observed
with thin liquids. There was no frank aspiration.
Cricopharyngeal opening: Normal.
FLUOROSCOPY TIME: 46 seconds of fluoroscopy time was used.

CPT: 74230
ICD- 787.20


EXAM TYPE:  Double contrast esophagram

HISTORY: dysphagia

TECHNIQUE:  Effervescent crystals were administered initially.  Under fluoroscopic control and thin and thick barium was administered by mouth and fluoroscopic spot images obtained
FINDINGS:  Barium passed through a normally motile esophagus.  Mucosa is normal.  No extrinsic defects identified.  No hiatal hernia or reflux was demonstrated during the examination.
IMPRESSIONS:  No definite acute or significant findings or definite interval change.  Fluoroscopy time 24 seconds.
CPT: 74220
ICD: 787.20

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