In simple words: This is an X-ray procedure to examine your salivary glands. A special dye is injected into the salivary ducts in your mouth to help them show up clearly on the X-ray images. The doctor watches the procedure and analyzes the images to check for problems like blockages, stones, inflammation, or tumors.

This code represents the professional and technical components of imaging supervision and interpretation of the salivary glands, typically the parotid gland. It involves injecting contrast medium into the salivary duct through a catheter placed in the oral cavity. The provider supervises the radiological procedure and interprets the images to diagnose conditions such as calculi (stones), blockages, inflammation, or tumors within the salivary glands or ducts. The procedure includes pre- and post-contrast injection imaging, as well as imaging after salivary stimulation (e.g., with lemon juice) to assess salivary flow and drainage.

Example 1: A patient presents with recurrent swelling and pain in the cheek, especially during meals. The physician suspects a salivary duct stone and orders a sialogram (70390) to confirm the diagnosis and assess the location and size of the stone., A patient with Sjögren's syndrome experiences persistent dry mouth and difficulty swallowing. A sialogram is performed to evaluate the salivary gland function and ductal morphology, aiding in the assessment of disease severity and guiding treatment decisions., A patient presents with a mass in the parotid gland. A sialogram is performed to evaluate the ductal system and differentiate between inflammatory conditions and tumors, aiding in surgical planning if necessary.

Documentation should include details of the procedure, including the type and amount of contrast used, the injection site, fluoroscopic findings, and the interpretation of the images. Any complications or adverse reactions should also be noted. The medical necessity for the procedure, such as relevant signs, symptoms, and previous diagnostic tests, should be clearly documented.

** While sialography has been partially replaced by newer imaging modalities such as CT, MRI, and ultrasound, it remains a valuable tool in specific scenarios, particularly when evaluating the salivary ductal system. The use of a closed system with a catheter helps minimize patient discomfort and improve image quality. It is important to exclude any contraindications to contrast media and inform the patient about potential complications such as infection or allergic reactions. Always refer to current coding guidelines and payer policies for the most up-to-date information.