CPT® Code 74248

Add-On Code

Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination)

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.