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Code deleted, see 74240

Official Description

Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A radiologic examination of the upper gastrointestinal (GI) tract, designated by CPT® Code 74241, involves the use of X-ray imaging to visualize the esophagus, stomach, and duodenum, which is the initial segment of the small intestine. This procedure employs indirect ionizing radiation to capture images of the body's internal structures, specifically targeting areas where there are variations in density and composition, such as human tissues. The X-ray technology allows for some rays to be absorbed by denser materials while others pass through, resulting in a two-dimensional representation of the anatomical features. This examination is crucial for diagnosing various gastrointestinal conditions, including ulcers, tumors, inflammation, hiatal hernias, scarring, obstructions, and any abnormal positioning or configuration of the organs. Patients typically present with a range of symptoms that may prompt this examination, including difficulty swallowing, chest or abdominal pain, vomiting, reflux, indigestion, or the presence of blood in the stool. The procedure generally commences with an anteroposterior (AP) scout film, which is a preliminary X-ray taken from front to back while the patient is either standing (erect) or lying down (supine). This initial imaging includes a KUB (kidneys, ureters, and bladder) view. Following this, the patient ingests a contrast medium orally, which is monitored under fluoroscopy as it travels through the esophagus into the stomach and duodenum. Spot films may be captured as needed during this process. Additionally, medications may be administered to either accelerate or delay the movement of the gastrointestinal tract and the contrast material. In cases where the movement is particularly slow, or to confirm the complete emptying of the contrast from the upper GI tract, delayed images may be necessary. It is important to note that CPT® Code 74240 is used for a similar radiologic examination of the upper GI tract without the KUB component, while CPT® Code 74241 is specifically designated for procedures that include the KUB imaging.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The radiologic examination of the upper gastrointestinal tract, as described by CPT® Code 74241, is indicated for a variety of gastrointestinal symptoms and conditions. These include:

  • Difficulty swallowing - Patients may experience challenges in swallowing, which can indicate underlying issues in the esophagus or other parts of the upper GI tract.
  • Chest or abdominal pain - Unexplained pain in these areas may necessitate imaging to identify potential gastrointestinal disorders.
  • Vomiting - Frequent or severe vomiting can be a sign of obstruction or other serious conditions that require evaluation.
  • Reflux - Symptoms of gastroesophageal reflux disease (GERD) may prompt the need for imaging to assess the esophagus and stomach.
  • Indigestion - Persistent indigestion can be indicative of various gastrointestinal issues that warrant further investigation.
  • Blood in the stool - The presence of blood can signal serious conditions such as ulcers or tumors, necessitating a thorough examination of the upper GI tract.

2. Procedure

The procedure for a radiologic examination of the upper gastrointestinal tract with KUB involves several key steps:

  • Step 1: Initial Scout Film - The examination begins with the acquisition of a single anteroposterior (AP) scout film. This X-ray is taken from front to back while the patient is positioned either erect or supine. The scout film includes imaging of the kidneys, ureters, and bladder (KUB), providing a baseline view of the abdominal area.
  • Step 2: Administration of Contrast Media - Following the scout film, the patient is instructed to orally ingest a contrast medium. This substance is crucial for enhancing the visibility of the upper GI tract structures during imaging.
  • Step 3: Fluoroscopic Monitoring - Under fluoroscopy, the movement of the contrast material is monitored as it travels down the esophagus into the stomach and duodenum. This real-time imaging allows for the assessment of the motility and function of the upper GI tract.
  • Step 4: Spot Films - As the contrast moves through the gastrointestinal tract, spot films may be taken at specific intervals or locations as indicated by the physician to capture detailed images of areas of interest.
  • Step 5: Medication Administration (if necessary) - In some cases, medications may be administered to either accelerate or delay gastrointestinal motility, facilitating a clearer understanding of the contrast's movement through the tract.
  • Step 6: Delayed Imaging (if required) - If the movement of the contrast is particularly slow, or to confirm the complete emptying of the contrast from the upper GI tract, delayed images may be obtained to ensure comprehensive evaluation.

3. Post-Procedure

After the completion of the radiologic examination, patients may be monitored for any immediate reactions to the contrast media. It is common for patients to be advised to drink plenty of fluids to help flush the contrast material from their system. Additionally, they may be informed about potential side effects, such as mild abdominal discomfort or changes in bowel habits, which can occur following the procedure. Patients should also be instructed to report any unusual symptoms, such as severe pain or allergic reactions, to their healthcare provider. Follow-up appointments may be scheduled to discuss the results of the examination and any further diagnostic or therapeutic steps that may be necessary based on the findings.

Short Descr X-RAY UPPER GI DELAY W/KUB
Medium Descr RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB
Long Descr Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB
Status Code Active 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 STV-Packaged Codes
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I1D - Standard imaging - contrast gastrointestinal
MUE Not applicable/unspecified.
CCS Clinical Classification 185 - Upper gastrointestinal X-ray
Date
Action
Notes
2019-12-31 Deleted Code deleted, see 74240
2016-01-01 Changed Description Changed
2013-01-01 Changed Short Descriptor changed.
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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