Radiology Coding Alert

Question: I'm currently using an unlisted code for a defogram. Is this correct?

Answer: According to AMA's CPT Assistant (May 2003), the correct code for a defogram (also known as a defecating proctogram or defecogram) is 74270 (Radiologic examination, colon; contrast [e.g., barium] enema, with or without KUB). Note that this is the updated 2009 74270 descriptor.

Caution: Some coders report that their individual payers have different preferences. For example, one practice's local Medicare requires an unlisted code, such as 76499 (Unlisted diagnostic radiographic procedure).But the local Medicaid administrator requires 74270 with modifier 52 (Reduced services).

Bottom line: Use 74270 unless the payer has published instructions to the contrary.