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Official Description

Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 74340 involves the introduction of a long gastrointestinal tube, such as a Miller-Abbott tube, utilizing fluoroscopic guidance. This procedure is essential for various diagnostic and therapeutic purposes, particularly in managing gastrointestinal conditions. The long gastrointestinal tube is typically inserted through the patient's nose or mouth and advanced into the stomach. This method allows for the aspiration of gastric secretions, which can be crucial for testing or relieving pressure in the stomach. Additionally, the procedure may involve the instillation of irrigation fluids or contrast media, which aids in isolating areas of damage within the gastrointestinal tract or producing clear radiological images for further evaluation. In cases where a double lumen tube is employed, one of the lumens may feature a balloon at its tip, which can be inflated to facilitate the tube's advancement through the pylorus and into the duodenum, enhancing the effectiveness of the procedure. The use of a guidewire or stylet may also be incorporated to assist in maneuvering the tube within the stomach and through the pylorus. Throughout the procedure, multiple fluoroscopic images are captured to confirm the correct placement of the tube within the stomach and its progression into the small intestine, while also documenting any potential obstructions or abnormal findings. This comprehensive approach includes all necessary radiological supervision and interpretation of the images obtained during the procedure, ensuring accurate assessment and management of the patient's condition.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 74340 is indicated for various gastrointestinal conditions that require the placement of a long gastrointestinal tube. The following are specific indications for performing this procedure:

  • Gastric Decompression - The procedure is performed to relieve pressure in the stomach by aspirating gastric secretions.
  • Diagnostic Testing - It is indicated for obtaining gastric secretions for laboratory analysis to diagnose gastrointestinal disorders.
  • Contrast Studies - The introduction of contrast medium may be necessary to visualize specific areas of the gastrointestinal tract for diagnostic imaging.
  • Management of Obstructions - The procedure can assist in identifying and managing obstructions or abnormal pathologies within the gastrointestinal tract.

2. Procedure

The procedure for the introduction of a long gastrointestinal tube involves several critical steps to ensure proper placement and functionality. The following outlines the procedural steps:

  • Step 1: Preparation - The patient is positioned appropriately, and the necessary equipment, including the long gastrointestinal tube, fluoroscopy machine, and contrast media, is prepared for use.
  • Step 2: Insertion of the Tube - The long gastrointestinal tube is carefully inserted through the patient's nose or mouth. The clinician ensures that the tube is advanced gently to minimize discomfort and complications.
  • Step 3: Fluoroscopic Guidance - As the tube is advanced, fluoroscopic imaging is utilized to monitor its progress. This real-time imaging allows for adjustments to be made as necessary to ensure accurate placement.
  • Step 4: Aspiration and Instillation - Once the tube is correctly positioned in the stomach, gastric secretions are aspirated for testing. Additionally, irrigation fluids or contrast medium may be instilled through the tube to enhance imaging and assess the gastrointestinal tract.
  • Step 5: Verification of Placement - Multiple fluoroscopic images are obtained to confirm the tube's placement in the stomach and its advancement into the small intestine. This step is crucial for documenting any obstructions or abnormal findings.
  • Step 6: Radiological Supervision and Interpretation - Throughout the procedure, radiological supervision is provided, and the images obtained are interpreted to ensure accurate assessment and management of the patient's condition.

3. Post-Procedure

After the completion of the procedure, the patient may require monitoring to assess for any complications or adverse effects related to the tube placement. The healthcare provider will evaluate the effectiveness of the tube in decompressing the stomach and facilitating the aspiration of gastric contents. Instructions regarding the care of the tube, potential signs of complications, and follow-up appointments for further evaluation or removal of the tube will be provided to the patient. It is essential to ensure that the patient understands the importance of reporting any unusual symptoms or discomfort following the procedure.

Short Descr X-RAY GUIDE FOR GI TUBE
Medium Descr INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I
Long Descr Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation
Status Code Carriers Price the 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 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) I1D - Standard imaging - contrast gastrointestinal
MUE 1
CCS Clinical Classification 185 - Upper gastrointestinal X-ray
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
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.
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.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
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
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
SA Nurse practitioner rendering service in collaboration with a physician
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
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
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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Action
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2016-01-01 Changed Description Changed
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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