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A radiologic small intestine follow-through study, identified by CPT® Code 74248, is a specialized imaging procedure that focuses on the upper gastrointestinal (GI) tract, specifically targeting the small intestine after the ingestion of a contrast material, typically barium sulfate. This procedure is part of a broader upper GI examination that includes imaging of the esophagus, stomach, and duodenum, which is the initial segment of the small intestine. The use of X-ray imaging in this context leverages the principles of ionizing radiation to create detailed images of the internal structures of the body. The varying densities and compositions of human tissues allow for some X-rays to be absorbed while others pass through, resulting in a two-dimensional representation of the organs and tissues being examined. The primary purpose of this follow-through study is to provide additional diagnostic information that may not be fully captured during the initial upper GI examination. It is particularly useful for identifying conditions such as ulcers, tumors, inflammation, hiatal hernias, scarring, obstructions, and any abnormal positioning or configuration of the gastrointestinal organs. Patients undergoing this procedure may present with a range of symptoms, including difficulty swallowing, chest or abdominal pain, vomiting, reflux, indigestion, or the presence of blood in the stool. The follow-through study typically commences with an anteroposterior (AP) abdominal scout film, which is obtained in either an erect or supine position prior to the administration of the contrast material. This initial imaging, known as a KUB (kidneys, ureters, and bladder), provides a baseline view of the abdominal organs. Following this, the patient ingests the barium sulfate mixture, which coats the esophagus and stomach, allowing for enhanced visualization during the imaging process. In cases where a double contrast study is performed, air is introduced in addition to the barium, further improving the clarity of the images. The procedure may also involve the administration of glucagon to relax the muscles in the area being examined, facilitating better imaging results. As the barium progresses through the gastrointestinal tract, fluoroscopic X-ray images are captured, and delayed images may be taken to assess the movement of the contrast material through the small intestine. It is important to note that not all images may be available for immediate review, and the follow-through study is billed separately using CPT® Code 74248 when multiple X-ray images of the small intestine are obtained as part of this comprehensive examination.
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The radiologic small intestine follow-through study (CPT® Code 74248) is indicated for a variety of gastrointestinal conditions and symptoms. The following are explicitly provided indications for performing this procedure:
The procedure for a radiologic small intestine follow-through study involves several key steps that ensure comprehensive imaging of the upper gastrointestinal tract. The following procedural steps are outlined:
After the completion of the radiologic small intestine follow-through study, patients may be monitored for any immediate reactions to the barium sulfate contrast material. It is common for patients to be advised to drink plenty of fluids to help flush the barium from their system. Additionally, they may be informed about potential changes in bowel habits following the procedure, such as temporary constipation or lighter-colored stools due to the barium. Any specific post-procedure care instructions should be provided by the healthcare professional conducting the study, ensuring that patients are aware of what to expect during their recovery period.
| Short Descr | X-RAY SM INT F-THRU STD | Medium Descr | RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY | Long Descr | Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 74240 | MPFS Status: Active Code APC Q1 ASC Z3 Physician Quality Reporting Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study | 74246 | MPFS Status: Active Code APC Q1 ASC Z3 Physician Quality Reporting Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | GC | This service has been performed in part by a resident under the direction of a teaching physician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CG | Policy criteria applied | CR | Catastrophe/disaster related | FY | X-ray taken using computed radiography technology/cassette-based imaging | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2020-01-01 | Added | Code added. |
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