Otolaryngology Coding Alert

Question: I’m looking to code a fluoroscopic swallowing function evaluation, but the only code I can find, 74230, seems to be a radiologic code. Should I use this code to report the speech pathologist’s services?

Michigan Subscriber

Answer: A fluoroscopic swallowing function evaluation actually consists of two services — one by the speech pathologist and one by the radiologist. The radiologist’s services (supervision and interpretation) are included in code 74230 (…swallowing function, with cineradiography/videoradiography…), but you’ll be reporting a separate code for the speech pathologist’s services.

In fact, if you look at the parenthetical notes underneath 74230, you’ll read the following:

•  “(For otorhinolaryngologic services fluoroscopic evaluation of swallowing function, use 92611 (Motion fluoroscopic evaluation of swallowing function by cine or video recording).”

The speech pathologist, much like the radiologist, is performing a supervision and interpreting the results of the examination into a formal report. While the radiologist will typically append modifier 26 (Professional Services) to 74230 to identify that their services are separate from the technical component (TC) of the examination, you do not need to do the same when submitting 92611 on behalf of the speech pathologist.