CPT® Code 74230

Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study

A radiologic examination of swallowing function, identified by CPT® Code 74230, involves the use of cineradiography or videoradiography techniques to assess the swallowing capabilities of patients, particularly those experiencing dysphagia. This procedure is crucial for evaluating the dynamics of swallowing and identifying any abnormalities that may lead to complications such as aspiration. The examination typically begins with scout neck radiographs, which are preliminary images taken to establish a baseline before the administration of contrast material, commonly barium. The patient is positioned upright or semi-reclining to facilitate the examination, allowing for optimal visualization of the head and neck during the swallowing process. Various textures and quantities of food and liquids, prepared with the contrast medium, are administered to the patient. The fluoroscopic recording captures the intricate movements involved in swallowing, including the actions of the tongue, larynx, and pharynx, as well as the opening of the pharyngoesophageal segment. This detailed imaging helps in documenting the coordination of muscle movements and identifying any instances of penetration or aspiration into the upper airways. Additionally, delayed images may be taken if the swallowing process is slow or to confirm the complete emptying of the contrast material. The physician subsequently reviews the recorded study and generates a comprehensive written report, which may include inferred measurements of muscle sensation and strength based on the observations made during the procedure.