How To Use CPT Code 74210

CPT 74210 describes the radiologic examination of the pharynx and/or cervical esophagus using contrast, including scout neck radiograph(s) and delayed image(s) if performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 74210?

CPT 74210 can be used to describe the radiologic examination of the pharynx and/or cervical esophagus using contrast. This procedure involves taking images of the throat and neck area to evaluate the structure and identify any abnormalities. The provider may use barium sulfate or other contrast agents to enhance the images for better evaluation.

2. Official Description

The official description of CPT code 74210 is: ‘Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study.’

3. Procedure

1. The provider positions the patient appropriately and passes the radiation beam through the neck.
2. Plain images of the throat and neck area are taken before the patient swallows contrast, such as barium sulfate.
3. Images are recorded digitally or on film, including images taken while the contrast coats the throat and cervical esophagus.
4. Based on initial findings, the provider may take additional delayed images hours after the initial imaging.
5. The provider analyzes the structure of the pharynx and/or cervical esophagus to rule out or identify any abnormalities.
6. A report of the findings is prepared by the provider.

4. Qualifying circumstances

CPT 74210 is used for patients who require a radiologic examination of the pharynx and/or cervical esophagus. This procedure is typically performed to evaluate the structure and identify any abnormalities in these areas. The use of contrast, such as barium sulfate, may be necessary to enhance the images for better evaluation.

5. When to use CPT code 74210

CPT code 74210 should be used when a radiologic examination of the pharynx and/or cervical esophagus is performed using contrast. This code is appropriate when the provider takes scout neck radiograph(s) and delayed image(s) if necessary. It is important to note that this code should not be reported if the procedure does not involve the use of contrast or if only plain images are taken without any additional imaging.

6. Documentation requirements

To support a claim for CPT 74210, the provider must document the following information:

• Reason for the radiologic examination and the need for contrast
• Type of contrast used, such as barium sulfate
• Date of the procedure
• Start and end time of the procedure
• Details of the images taken, including scout neck radiograph(s) and delayed image(s) if performed
• Findings and any abnormalities identified
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 74210, ensure that the procedure involves the use of contrast and includes scout neck radiograph(s) and delayed image(s) if performed. If only the physician’s interpretation is being reported, append modifier 26 to the radiology code. If only the technical component is being reported, append modifier TC to the radiology code. However, it is important to check payer policies as hospitals may be exempt from appending modifier TC. If the provider renders both the professional and technical components, do not append any modifiers to the radiology code.

8. Historical information

CPT 74210 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2020, to its current description.

9. Examples

1. A patient undergoes a radiologic examination of the pharynx and cervical esophagus using contrast to evaluate swallowing difficulties.
2. A scout neck radiograph and delayed images are taken during a radiologic examination of the pharynx and cervical esophagus using contrast to assess the presence of a foreign body.
3. A patient with suspected esophageal abnormalities undergoes a radiologic examination of the pharynx and cervical esophagus using contrast, including scout neck radiograph(s) and delayed image(s) if necessary.
4. A provider performs a radiologic examination of the pharynx and cervical esophagus using contrast to evaluate the structure and identify any abnormalities in a patient with persistent throat pain.
5. A scout neck radiograph and delayed images are taken during a radiologic examination of the pharynx and cervical esophagus using contrast to assess the effectiveness of previous treatment for esophageal strictures.
6. A patient with difficulty swallowing undergoes a radiologic examination of the pharynx and cervical esophagus using contrast, including scout neck radiograph(s) and delayed image(s) if necessary, to determine the cause of the symptoms.
7. A provider performs a radiologic examination of the pharynx and cervical esophagus using contrast to evaluate the structure and identify any abnormalities in a patient with suspected esophageal cancer.
8. A scout neck radiograph and delayed images are taken during a radiologic examination of the pharynx and cervical esophagus using contrast to assess the effectiveness of treatment for gastroesophageal reflux disease (GERD).