Barium Swallow CPT Codes | Code Descriptions & Billing Guide

The Barium Swallow CPT Codes are CPT 74220 and CPT 74230. These codes can be used for an esophageal exam for Normal Barium swallows and for modified Barium swallow. Both tests detect esophageal function problems, such as a hiatal hernia or gastroesophageal reflux disease. 

GI reflux and hiatal hernia are always medical reasons for a barium swallow. The entire barium swallow study, which has CPT 70370, CPT 70371, and CPT 74230, can charge once to the patient. On the same day of service, only one of these CPT codes can also bill per patient.

When coding procedure codes, the diagnosis is critical. Additional diagnostic tests for which procedure codes exist include HIDA scans (CPT 78226 & CPT 78227), bone scans, mammograms, chest x-rays, abdominal ultrasounds, and MRI exams.

 Upper gastrointestinal series codes also include barium swallow exams (74240-74250). The signs and symptoms of both procedures are similar. Coding these tests will undoubtedly assist you in improving your coding abilities.

 This test can not perform during the pregnancy period. Some payers in the United States may require a more specific primary and secondary diagnosis for a modified barium swallow. It can also report as CPT 74220: “oesophageal radiologic examination.”

Before and after the examination, fluoroscopic images of the esophagus can take using barium sulfate.

This test, also known as a “Barium swallow,” assesses the ability to swallow barium sulfate. With the help of this research, reflux and varies in the esophagus can detect. The number or type of views has no bearing on this exam. 

A more thorough oesophageal examination, particularly of the cervical esophagus, involving multiple patient positions, video or cine recording, and dual contrast may be required if a patient’s symptoms warrant it.

It is possible to report both an upper GI code (74240-74249) and a “radiologic examination, pharynx and cervical esophagus” code (74210).

Barium Swallow CPT Codes Descriptions

Barium Swallow CPT codes are CPT 74220 and CPT 74230 and are described by the CPT manual as:

CPT 74220: “Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study.”

CPT 74230: “Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study.”

CPT code 74230 can be used in the Diagnostic Radiology (Diagnostic Imaging) Procedures of the Gastrointestinal Tract.

Using barium sulfate contrast and cineradiography/video radiography, the healthcare provider can see and document the patient’s swallowing pattern; if necessary, scout neck films and delayed images can also obtain as part of this process.

Fluoroscopy and an oral contrast agent known as barium can use to perform a barium swallow. Fluoroscopy allows the movement of internal organs can observe. In barium-coated specimens, radiologists can examine the anatomy and function of the pharynx and esophagus.

 Baking soda crystals (similar to Alka-Seltzer) will use as a barium supplement. It is an air-contrast or double-contrast procedure for the upper gastrointestinal tract.

The exam table may be angled differently. The radiologist will use a fluoroscope to project radiographic images in a movie-like sequence onto a monitor. At the same time, you drink the barium liquid, which tastes like a light-colored milkshake.

 After the barium has sufficiently coated the gastrointestinal tract, X-ray images will take to help disperse the barium. Children regularly consume barium contrast medium without incident. The radiologist may need to insert a small tube into the child’s stomach to complete the exam.

To reduce the risk of blurred images, you can ask to stop breathing for a short period. Baking soda crystals will be used as an anesthetic during the procedure because they produce gas in the stomach when consumed.

The pharynx and pharyngeal segments and the length of the pharyngoesophageal segment opening can also examine. This test should take no more than 20 minutes to complete in general.

The Modified Barium Swallow (MBS), also known as the Videofluoroscopic Swallowing Study (VFSS), is a videofluoroscopic, radiographic test that differs in both method and objective from the traditional barium swallow procedure.

 A contrast material is mixed with various amounts and textures of food and liquids while the patient is seated upright or semi-reclined.

Standing allows you to follow or infer muscle strength, sensation, and esophageal clearance. Food and liquid retention, mastication, and tongue movement during oral bolus transport are all observed during the process. 

A radiologist and a speech-language pathologist can collaborate to complete the videofluoroscopic swallowing study. The pregnant woman can not go through this CTP code and will also restrict by the physician.

During swallowing tests, barium can use to improve X-ray visibility of specific body regions. The radiologist can see the size and shape of the pharynx and esophagus. They will be able to see you swallowing as well. These details can obscure by a standard X-ray. 

Barium can only use in GI tract imaging tests. In addition to or instead of an upper GI series, a barium swallow test can perform. This series looks at the esophageal, stomach, and the first segment of the small intestine (duodenum). 

The risks of having a barium swallow test include radiation exposure, congenital disabilities, and intestinal problems.

If you are concerned about the radiation exposure from the swallowing test, speak with your doctor. All of your X-rays, including those taken for non-medical reasons such as pregnancy, should be documented. 

Billing Guidelines For Barium Swallow CPT Codes

A barium swallow exam can consist of the more involved modified barium swallow procedure. The Barium Swallow CPT Codes include the modified barium swallow CPT 74220 and CPT 74230. This code pair does not support any CCI-related modifiers.

CPT 92610 can use to document a clinical evaluation of feeding and swallowing. (Oral and pharyngeal swallowing function evaluation) discuss CPT 92526 (treatment of swallowing dysfunction and oral function for feeding) with your healthcare provider.

If the patient has undergone an MBS or videofluoroscopic study, speech-language pathologists are responsible for reporting CPT 92611.

The radiologist’s role (swallowing function with cineradiography/video radiography) describes in CPT 74230, which can not use.

The CPT codes 92612-92617 can use to report flexible endoscopic swallowing and laryngeal sensory testing via cine or video recording.

Use the “interpretation and reporting only” codes in this series if your role is limited to interpreting and reporting results (i.e., you do not meet the scope). “Interpretation and report only” code sets cannot use with complete endoscopic evaluation codes.

Patients with dysphagia who have pharyngeal dysfunction or are at risk of aspiration should have an instrumental swallowing assessment.

Dysphagia is influenced by several clinical syndromes, including but not limited to:

• Patients who are disabled due to a stroke or another neurological condition affecting the central nervous system (CNS).
• Patients with head and neck cancer radiation or surgery have difficulty swallowing.
• Patients with a history of swallowing problems can evaluate if there is no apparent CNS disorder.

The patient will be eligible for an upper GI exam cost under your Medicare Part B (medical insurance) policy. The exam is essential to qualify for Medicare Part B benefits.

The entire barium swallow study is denoted by CPT codes 70370, 70371, and 74230, and each patient should only be charged once for the exact service date. Only one of these CPT codes should assign to each patient on the same day of service.

The contractor must always have access to the patient’s medical record documentation.

How To Use Modifier 59 For The Barium Swallow CPT Codes

The modifier used for the CTP Code of Barium Swallow is Modifier 59. Although modifier 59 significantly impacts Medicare reimbursements, it is the one that physical therapists struggle with the most.

This modifier can only use if the therapist performs the two procedures at distinct 15-minute intervals. Because of the time limit, you cannot submit both codes simultaneously. The CPT Manual may not be the most reliable source of information.

Adding modifier 59 to the CTP code 74230 with the upper gastrointestinal procedure is unnecessary because the swallowing function is performed and reported separately. CCI edits do not include this code.

Modifier 59 will use to identify procedures and services that are not commonly reported together but are appropriate under the circumstances.

Reimbursement

The cost-benefit analysis of MBSS versus FEE (Federal Emissions Elimination System) is straightforward. If you’ve arrived at the right place: An Modified Barium Swallow (MBS) typically costs between $1400 and $1700.

Radiology fees and Medicare Part B transportation costs total around $900, so your facility is still on the hook for that.

Patients transported outside your facility require a companion, which presents several challenges. Having the patient outside your facility reduces productivity, complicating matters further (affecting your RUGs).

Patients receiving MBSS in a hospital can frequently prescribe a restrictive or nectar-thick diet. Patients who will diagnose before returning to your facility may continue to consume nectar-heavy diets, costing your facility up to $7,000 per resident per year!

Examples

The doctor will refer the patient to a nearby radiology facility for a barium swallow test. A certified radiology technician will carry out the procedure. Barium takes about 30 minutes to swallow. 

The patient will receive the results of the system within a few days. When the patient arrives at the radiology facility, they will ask to remove all of their clothing and jewelry and place them in a locker. 

A patient will be placed on an X-ray table by technicians. Routine X-rays of the chest, abdomen, and heart may necessitate the patient to adjust their body position. The technician will then give you a lighter version of the barium solution to drink. The barium’s progress down the esophagus will monitor using X-rays or fluoroscopy.