RadVCCoder
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I work for a group of radiologist. They are contracted with the local hospital. When doing a 74230 (Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study) we have always added modifier 26. However today we received a message from someone in the hospitals coding department asking how we bill these and if we include a modifier (please see below as I have attached her email specifically. How are other radiologist billing this out? should we not be adding modifier 26?
The email we received:
How does XYZ bill for the professional billing for 74230? Is there a modifier required? I am not familiar with physician billing. Modifier 26 is only used if the radiologist does not perform the exam. In this case, the radiologist does the fluoroscopy. Thanks.
CPT
Code
74230
Long Description
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study
Medium Description
RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY
Short Description
X-RAY XM SWLNG FUNCJ C+
Consumer Friendly Description
Imaging for evaluation of swallowing function
Plain English Description
A radiologic study with cineradiography/videoradiography is performed with contrast to assess swallowing function in patients with dysphagia. A swallowing function study (modified barium swallow, MBS) may be indicated for patients with a history of stroke or other central nervous system disorders, surgery, radiation to the head or neck, neuromuscular or rheumatologic disease, generalized debilitation, and head/neck/throat injury including peripheral nerve injury. The exam may begin with one or more scout radiograph(s) of the neck taken before contrast is administered. The patient is seated upright or semi-reclining with the fluoroscopy machine focused on the head and neck. Food and liquids of various texture and quantity are mixed or soaked in contrast medium (barium) and administered to the patient. A fluoroscopic recording is made of the food or fluid in the oral cavity, larynx, pharynx, and upper esophagus to document mastication and tongue mobility, elevation and retraction of the velum, tongue base retraction and movement of the hyoid bone and larynx, closure of the larynx, contraction of the pharynx, and the duration and extent of pharyngoesophageal segment opening. Observation and recording are made of any penetration or aspiration of food and fluid into the upper airways. Delayed images may be required of movement is very slow or to verify emptying of the contrast. All images from this procedure may not be available for immediate viewing. The physician reviews the study and provides a written report. The measurement of muscle sensation and strength may be inferred or calculated directly from the information obtained during the study.
See Less
Effective Date
01/01/1990
The email we received:
How does XYZ bill for the professional billing for 74230? Is there a modifier required? I am not familiar with physician billing. Modifier 26 is only used if the radiologist does not perform the exam. In this case, the radiologist does the fluoroscopy. Thanks.
CPT
Code
74230
Long Description
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study
Medium Description
RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY
Short Description
X-RAY XM SWLNG FUNCJ C+
Consumer Friendly Description
Imaging for evaluation of swallowing function
Plain English Description
A radiologic study with cineradiography/videoradiography is performed with contrast to assess swallowing function in patients with dysphagia. A swallowing function study (modified barium swallow, MBS) may be indicated for patients with a history of stroke or other central nervous system disorders, surgery, radiation to the head or neck, neuromuscular or rheumatologic disease, generalized debilitation, and head/neck/throat injury including peripheral nerve injury. The exam may begin with one or more scout radiograph(s) of the neck taken before contrast is administered. The patient is seated upright or semi-reclining with the fluoroscopy machine focused on the head and neck. Food and liquids of various texture and quantity are mixed or soaked in contrast medium (barium) and administered to the patient. A fluoroscopic recording is made of the food or fluid in the oral cavity, larynx, pharynx, and upper esophagus to document mastication and tongue mobility, elevation and retraction of the velum, tongue base retraction and movement of the hyoid bone and larynx, closure of the larynx, contraction of the pharynx, and the duration and extent of pharyngoesophageal segment opening. Observation and recording are made of any penetration or aspiration of food and fluid into the upper airways. Delayed images may be required of movement is very slow or to verify emptying of the contrast. All images from this procedure may not be available for immediate viewing. The physician reviews the study and provides a written report. The measurement of muscle sensation and strength may be inferred or calculated directly from the information obtained during the study.
See Less
Effective Date
01/01/1990