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The procedure described by CPT® Code 74360 involves the intraluminal dilation of strictures and/or obstructions within the esophagus, utilizing radiological supervision and interpretation. Intraluminal dilation is a therapeutic intervention aimed at widening narrowed areas of the esophagus, which can occur due to various pathological conditions. Strictures are defined as constricted segments of the esophagus that can result from several factors, including abnormal growths, peptic injuries caused by gastric acid reflux, the presence of Schatzki's ring or esophageal web, caustic injuries, radiation damage, or scarring following surgical procedures. Strictures can be categorized into two types: simple and complex. Simple strictures are typically characterized by a straight configuration and a length of less than 2 centimeters, while complex strictures are generally longer than 2 centimeters and may exhibit irregular shapes or significant narrowing. The procedure often employs fluoroscopy, a type of real-time X-ray imaging, to guide the insertion of instruments such as weighted bougies, guidewires, or balloons into the esophagus. This imaging technique is particularly beneficial for complex strictures, especially when previous endoscopic interventions have not yielded successful results. During the procedure, the selected instrument is carefully advanced through the oral cavity and into the esophagus, reaching the site of the stricture. Once in position, the narrowed area is gradually dilated by applying pressure with progressively larger dilators until the desired enlargement is achieved. The use of CPT® Code 74360 specifically pertains to the radiological supervision and interpretation that accompanies this intraluminal dilation procedure, ensuring that the intervention is performed safely and effectively under imaging guidance.
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The intraluminal dilation of strictures and/or obstructions in the esophagus is indicated for various conditions that lead to narrowing of the esophageal lumen. These indications include:
The procedure for intraluminal dilation of esophageal strictures involves several key steps that ensure effective treatment of the narrowed areas. The process begins with the patient being positioned appropriately for the procedure, often under fluoroscopic guidance to visualize the esophagus in real-time. The physician selects an appropriate instrument, which may include a weighted bougie, guidewire, or balloon, depending on the specific characteristics of the stricture being treated.
Following the intraluminal dilation procedure, patients are typically monitored for a short period to assess for any immediate complications or adverse reactions. It is common for patients to experience some discomfort or a sensation of fullness in the esophagus, which usually resolves quickly. The physician may provide specific post-procedure care instructions, including dietary modifications, such as starting with soft foods and gradually reintroducing regular diet as tolerated. Patients are also advised to report any unusual symptoms, such as severe pain, difficulty swallowing, or signs of infection. Follow-up appointments may be scheduled to evaluate the effectiveness of the dilation and to determine if further interventions are necessary.
| Short Descr | X-RAY GUIDE GI DILATION | Medium Descr | INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I | Long Descr | Intraluminal dilation of strictures and/or obstructions (eg, esophagus), 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 | 226 - Other diagnostic radiology and related techniques |
| 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 | 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. | CR | Catastrophe/disaster related | 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). | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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 | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 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 | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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