How To Use CPT Code 74250

CPT 74250 describes the radiologic examination of the small intestine, including multiple serial images and scout abdominal radiograph(s), when 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 74250?

CPT 74250 can be used to describe the radiologic examination of the small intestine. This procedure involves taking X-rays of the small intestine after infusing single-contrast barium through a tube passed through the nose or mouth, down the throat, and into the duodenum or small intestine. The service also includes a scout film taken before the contrast is instilled, if performed, and sequential X-ray exposures after the instillation of the contrast.

2. Official Description

The official description of CPT code 74250 is: ‘Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study.’

3. Procedure

1. The provider places the patient in the prone position and acquires one or more scout films of the abdomen prior to intubation and contrast administration.
2. Using fluoroscopic guidance, the provider inserts a tube through the patient’s nose or mouth and throat and then into the stomach and the beginning of the small bowel.
3. The provider administers a contrast such as barium and takes multiple X-ray films to image all the loops of the small bowel as the contrast flows through the bowel.
4. The provider also observes the flow of barium via fluoroscopy and the patient may need to change positions during the exam.
5. The provider reviews the images and writes a report.

4. Qualifying circumstances

CPT 74250 is performed to detect lesions and other disorders or diseases of the small intestine. It is typically done when there is a need to visualize the small intestine using a single-contrast study with barium. The patient may be appropriately prepared and usually sedated for the procedure.

5. When to use CPT code 74250

CPT code 74250 should be used when a provider performs a radiologic examination of the small intestine using a single-contrast study with barium. It is important to note that this code should not be reported in conjunction with codes 74248 and 74251.

6. Documentation requirements

To support a claim for CPT 74250, the provider must document the following information:

• Patient’s preparation and sedation, if applicable
• Performance of scout abdominal radiograph(s), if performed
• Details of the tube insertion and contrast administration
• Sequential X-ray exposures and fluoroscopic guidance
• Observations of the flow of barium and any necessary position changes
• Review of the images and written report

7. Billing guidelines

When billing for CPT 74250, ensure that the procedure meets the criteria for a radiologic examination of the small intestine using a single-contrast study with barium. It is important to note that this code should not be reported with codes 74248 and 74251. If reporting only the physician’s interpretation, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, payer policy may exempt hospitals from appending modifier TC. If reporting a global service in which one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 74250 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including updates to the description and inclusion of multiple serial images.

9. Examples

1. A patient undergoes a radiologic examination of the small intestine using a single-contrast study with barium to detect any abnormalities or diseases.
2. A provider performs a scout abdominal radiograph before intubation and contrast administration, followed by sequential X-ray exposures to image the loops of the small bowel.
3. A patient is appropriately prepared and sedated for the procedure, and the provider reviews the images and writes a report.
4. A radiologic examination of the small intestine is performed to visualize the small bowel using a single-contrast study with barium.
5. The provider uses fluoroscopic guidance to insert a tube through the patient’s nose or mouth and throat, administers the contrast, and observes the flow of barium via fluoroscopy.