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CPT code for Barium Swallow Coding guide

Basic – Cpt Code for Barium Swallow

Barium swallow studies are coded very frequently in radiology. Studies related to esophagus are done with Barium swallow. Any problem with food swallowing procedures always make physicians to test with barium swallow studies. Barium swallow are has two CPT codes 74220 and 74230, normal Barium swallow and Modified Barium swallow. Both are done to find any abnormalities like hiatal hernia or gastroesophageal reflux (K21.9), related to swallowing function of esophagus. Both procedures have common sign and symptoms. Modified barium swallow requires more specific diagnosis as primary and secondary, to be get paid for some payers in US.

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CPT code for Barium Swallow learning tips

Procedure for CPT code for Barium Swallow

The study is performed on esophagus, a muscular tube, which carried swallowed food and liquids for the pharynx to stomach. Contrast material is introduced in esophagus and films are taken before and after the exam. Here, Barium sulphate is introduced and fluoroscopic films of esophagus are obtained before and after the exam. The swallowing function of esophagus is examined through the use of barium sulphate hence this exam is also referred as “Barium swallow”. Abnormalities related to esophagus like reflux, varices etc. are diagnosed with this study. Number and type of views have nothing to do with this exam.

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Procedure for CPT code for Barium Swallow Modified

Modified Barium swallow is slightly advanced compared to barium swallow. In this procedure the patient is placed in upright position and foods and liquids are mixed with barium and given to patient. Fluoroscopic images are obtained once the patient swallows the food and liquids. Here, images are recorded with the help of video recorder which can use for later study as well. So, at this point normal Barium swallow is different from Modified Barium Swallow. In the procedure physician examine behavior of food and liquid in mouth, chewing, swallowing and movement of food in esophagus. Images taken during these process helps in diagnosis of any abnormality related to swallowing function like gastro-esophageal reflux, obstruction, hiatal hernia etc.

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ICD9  and ICD10 code for CPT code for Barium Swallow

The most common symptom for Barium swallow study is dysphagia 787.20(R13.10). Difficulty in swallowing leads the harmful diseases like gastro-esophageal reflux, hiatal hernia etc. Hence, whenever we come across cpt 74220, 74230 we usually get 787.20 as symptom or indication. While coding Diagnosis codes for 74230 Modified Barium Swallow we use to code two ICD codes. The Primary codes should the symptom associated with difficult swallowing and the secondary code should be the disorder related to symptoms. 

ICD 9 and ICD 10 

Gastroesophageal reflux

530.81

K21.9

Hiatal Hernia

553.3

K44.9

 References:

http://www.acr.org/Advocacy/Economics-Health-Policy/Billing-Coding/Coding-Source-List/2009/May-Jun-2009/Coding-for-an-Upper-GI-Series-and-Esophagram

https://www.supercoder.com/coding-newsletters/my-radiology-coding-alert/you-be-the-coder-barium-swallow-article

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