CPT® Code 74249

Deleted

Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through

A radiological examination of the upper gastrointestinal (GI) tract, specifically coded as CPT® Code 74249, involves the use of advanced imaging techniques to visualize the esophagus, stomach, and duodenum, which is the initial segment of the small intestine. This procedure employs indirect ionizing radiation to capture images of the GI tract, taking advantage of the varying densities and compositions of human tissues. The process allows certain x-rays to be absorbed while others pass through, resulting in a two-dimensional representation of the internal structures. This examination is crucial for diagnosing a range of gastrointestinal conditions, including ulcers, tumors, inflammation, hiatal hernias, scarring, obstructions, and abnormal anatomical configurations. Patients typically present with symptoms such as difficulty swallowing, chest or abdominal pain, vomiting, reflux, indigestion, or the presence of blood in the stool, which may prompt the need for this diagnostic procedure. The examination often commences with an anteroposterior (AP) scout film, which is a preliminary x-ray taken in either an erect or supine position, capturing images of the kidneys, ureters, and bladder, collectively referred to as a KUB. For the air contrast study, the patient ingests a specific high-density barium sulfate mixture, which coats the esophagus and stomach, while also facilitating the buildup of air in the stomach as it is digested. Additionally, glucagon may be administered to relax the muscles in the area being examined, enhancing the clarity of the images obtained. X-ray images of the esophagus and stomach are captured as needed, and if the movement of the contrast is slow, delayed images may be taken to assess the emptying of the contrast material. It is important to note that not all images from this procedure may be available for immediate review, and specific coding is required based on the components of the procedure performed, such as using code 74246 for procedures without a KUB, or 74247 when a KUB is included, while CPT® Code 74249 is designated for instances where x-ray images of the small intestine are also captured following the administration of the barium sulfate mixture.