Coding Corner: January/February Issue

Q.  What type of documentation needs to be dictated for upper GI series and why?
 
A.  The CPT codes for upper GI are as follows:

74240 – Radiologic examination, gastrointestinal tract, upper: with or without delayed images, without KUB
74241 – Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB
74245 - Radiologic examination, gastrointestinal tract, upper; with small intestine, includes multiple serial images
74246 - Radiologic examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; or without delayed images, without KUB
74247 - Radiologic examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, with KUB
74249 - Radiologic examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through

The coders needs to determine from the documentation if barium only is used (CPT 74240 – 74245) or if double contrast or air contrast is used (CPT 74246 – 74249).  After the type of contrast is determined, then the coders must identify whether the imaging was done “without KUB”, “with KUB” or “with small intestines” based on the documentation.
 
Per Medlearn, if a preliminary view of the abdomen is done with an upper GI study, then it should be charged as a “with KUB” exam.