In simple words: This code covers the doctor's work in using X-rays to guide and interpret the placement of a special tube into the small intestine. The X-rays help ensure the tube is correctly positioned and can also help diagnose problems.

This code represents the physician's supervision and interpretation of radiological images taken during the insertion of a long gastrointestinal tube, such as a Miller-Abbott tube. The procedure involves multiple fluoroscopic images and films to guide the tube's placement and assess the small intestine. Contrast material may be administered to enhance visualization. This code does not include the tube placement itself (use 44500 for tube placement.)

Example 1: A patient presents with a suspected small bowel obstruction. A Miller-Abbott tube is inserted under fluoroscopic guidance, with 74340 billed for the radiological supervision and interpretation., A patient with a known small bowel stricture requires dilation. A long gastrointestinal tube with a balloon is inserted under fluoroscopic guidance, and the stricture is dilated. Code 74340 is reported for the radiological S&I., A patient experiences gastrointestinal bleeding. A long gastrointestinal tube is placed under fluoroscopy to locate the source of the bleeding. 74340 is billed for the radiological supervision and interpretation.

Documentation should include details of the fluoroscopic procedure, the type of tube inserted, the location of placement, any contrast used, and the physician's interpretation of the images. Any diagnoses or findings related to the imaging should also be documented.

** For rare instances where one provider supervises and another interprets, each provider reports 74340 with modifier 52 and 26. Modifier 26 is not necessary when reporting the global service. Payer policy may exempt hospitals from appending modifier TC.