Introduction about CPT code for upper GI

The codes for upper GI are very important. These codes are used very frequently in radiology coding. The coders have lot of confusion while coding CPT code for upper GI. The upper GI coding is little tricky due to use of single and double contrast. Cpt Code for Upper GI are few but hard to differentiate from one another. There are few things to remember, to code upper GI codes. Let’s check out the how to find out the correct CPT code for upper GI procedures.

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List of CPT code for upper GI

 The CPT code for upper GI is divided first on the use of single and double contrast. After that the codes for upper GI are divided with or without the performance of KUB.  Also we have codes for Small bowel follow through for single and double contrast. Cpt Code for upper GI can be easily coded if we easily filter out these keywords from the upper GI codes. Below is the list of CPT code for Upper GI

For Single Contrast & Double or Air contrast

74240- Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study

CPT code 74241 has been deleted, now we have to use CPT code 74240

CPT code 74245 has been deleted, now we have to use CPT code 74240, 74248

74246- Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed;  double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered

CPT code 74247 has been deleted, now we have to use CPT code 74246

+74248- Radiologic small intestine follow-through study, including multiple serial images (List separately in addition to code for primary procedure for upper GI radiologic examination)

CPT code 74249 has been deleted, now we have to use CPT code 74246, 74248

74250-  Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study

74251    Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered

For reporting CPT code 74250, a radiologic exam is performed of the small intestine. The patient is placed face down and x-rays are taken in a series of multiple images. The patient holds his or her breath during image taking. For reporting CPT code 74251, a radiologic exam of the small bowel is done by enteroclysis and taken in a series of multiple images. For enteroclysis, the physician inserts a tube through the patient’s mouth and passes it down into the stomach and the small intestine. The tube is connected to a pump that sends barium through the tube for visualizing the GI tract and small bowel.

Do not report 74240 in conjunction with 74220, 74221, 74246

Do not report 74246 in conjunction with 74220, 74221, 74240

Do not report 74248 in conjunction with 74250, 74251

Do not report 74250 in conjunction with 74248, 74251

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Important things to Check for Cpt code for Upper GI

There are few things to check for coding CPT code for upper GI. First always check for presence of single or double contrast. Single contrast is mostly mention as single contrast in medical report but for double contrast sometimes the physician mention as Air contrast, which also mean double contrast. Sometimes, they will not mention air contrast as well but, they will mention some effervescence crystals, in the technique which also mean the exam is done with double contrast.

Once, we have differentiated between single and double contrast we can check whether the exam is performed with or without KUB. KUB (kidney, urinary, Bladder) is an image taken for examination. Mostly the physician mention as “preliminary images were taken or obtained” or “Images were taken” or “preliminary films were taken” to document the presence of KUB in the report. So, such phrases help in differentiate whether the exam is done with KUB or without KUB. Once we have filtered these (contrast & KUB) thing we can easily reach out to correct code.

Hope, you will now easily code CPT code for upper GI in future. Please share it if you like the article.  

References:

https://www.radiologyinfo.org/en/info.cfm?pg=uppergi

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=p07701

http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/upper-gi-series/?region=on