How To Use CPT Code 74283

CPT 74283 describes a therapeutic enema procedure used to reduce intussusception or other intraluminal obstructions. 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 74283?

CPT 74283 is a code used to describe a therapeutic enema procedure. This procedure involves the injection of air or contrast material into the large intestine through an enema. The provider then uses a fluoroscope, a live X-ray camera, to monitor the progression and effect on a blockage. The purpose of this procedure is to flush out an obstruction in the intestines or unfold a portion of the intestine that has folded in on itself.

2. Official Description

The official description of CPT code 74283 is: ‘Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus).’ This code specifically refers to the use of an enema to reduce intussusception or other obstructions within the intestines.

3. Procedure

1. The provider begins by appropriately prepping and positioning the patient.
2. A small, soft tube is inserted into the rectum and advanced into the large intestine.
3. The provider then injects air or contrast material through the tube.
4. Using a fluoroscope, the provider monitors the flow of air or contrast material into the large intestine.
5. The pressure of the air or contrast material helps to unfold any in-folded portions of the intestine or loosen hardened waste matter, relieving the obstruction.
6. Once the procedure is complete, most of the air or liquid material is emptied through the tube or expelled by the patient.

4. Qualifying circumstances

CPT 74283 is used for patients who require a therapeutic enema to reduce intussusception or other intraluminal obstructions. Intussusception refers to an obstruction where one part of the intestine slides into or inverts into an adjoining part, resembling a collapsible telescope. Meconium ileus is a specific type of obstruction that occurs in newborns when their first stool, or meconium, is thicker and stickier than normal, causing a blockage. This procedure is performed by a provider who is trained and qualified to administer enemas and use fluoroscopy.

5. When to use CPT code 74283

CPT code 74283 should be used when a therapeutic enema is performed to reduce intussusception or other intraluminal obstructions. It is important to note that this code should not be used for diagnostic enemas or other procedures that do not involve the reduction of obstructions.

6. Documentation requirements

To support a claim for CPT code 74283, the provider must document the following information:

• Patient’s diagnosis indicating the need for a therapeutic enema
• Details of the procedure, including the use of air or contrast material
• Date and duration of the procedure
• Any complications or additional interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 74283, ensure that the procedure meets the criteria for a therapeutic enema to reduce intussusception or other intraluminal obstructions. It is important to use the appropriate diagnosis code to support the medical necessity of the procedure. Modifier 26 should be appended to the radiology code if only the physician’s interpretation is being reported. Modifier TC should be appended if only the technical component is being reported. However, payer policies may exempt hospitals from appending modifier TC. If both the professional and technical components are rendered by the same provider, no modifier is necessary.

8. Historical information

CPT code 74283 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a therapeutic enema using air to reduce intussusception in a pediatric patient.
2. A radiologist administers a therapeutic enema with contrast material to treat an intraluminal obstruction in an adult patient.
3. A gastroenterologist performs a therapeutic enema using air to reduce an intussusception in an elderly patient.
4. A pediatrician uses a therapeutic enema with contrast material to treat meconium ileus in a newborn.
5. A surgeon performs a therapeutic enema using air to reduce an intraluminal obstruction in a patient with a history of gastrointestinal issues.
6. A radiology technician assists a radiologist in performing a therapeutic enema with contrast material to treat an intussusception in a pediatric patient.
7. A gastroenterologist administers a therapeutic enema using air to reduce an intraluminal obstruction in a patient with a known gastrointestinal disorder.
8. A pediatric radiologist performs a therapeutic enema with contrast material to treat meconium ileus in a premature infant.
9. A surgeon uses a therapeutic enema with air to reduce an intussusception in a patient with a previous history of abdominal surgery.
10. A radiology technician assists a radiologist in performing a therapeutic enema with contrast material to treat an intraluminal obstruction in an elderly patient.