2025 CPT code 74230
Effective Date: N/A Revision Date: N/A Radiology Procedures > Diagnostic Radiology (Diagnostic Imaging) Procedures Feed
Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study.
Modifiers 26 (Professional Component) and TC (Technical Component) may be used. Payer policy may exempt hospitals from appending modifier TC. Do not append modifiers when reporting a global service.
Medical necessity for 74230 is established when there is clinical suspicion of swallowing dysfunction, such as difficulty swallowing, choking, or aspiration. The study helps determine the cause and severity of the swallowing problem, guide treatment decisions, and prevent complications like pneumonia.
In simple words: This procedure uses a moving X-ray and a special contrast dye called barium to create a video of your swallowing process. It helps doctors see how you swallow different foods and liquids, and identify any problems in your throat or esophagus.
The provider visualizes and records the patient’s swallowing pattern using barium sulfate contrast and cineradiography/videoradiography. Scout neck films and delayed images may be obtained and, if so, are included with this procedure.The patient is positioned upright and given food and drink of different amounts and consistencies mixed with barium. Prior to ingestion, scout films of the neck may be taken. The provider observes the swallowing pattern, including the motion of food, tongue mobility, and muscular contractions of the oropharynx, hypopharynx, and upper esophagus in real-time under fluoroscopic or other imaging guidance. Images are recorded with cineradiography/videoradiography for further evaluation. Based on initial findings, additional delayed films may be taken hours after the initial imaging. The provider analyzes the images and prepares a report.
Example 1: A 70-year-old male with a history of stroke presents with difficulty swallowing. A modified barium swallow study (74230) is performed to evaluate his swallowing function and identify any areas of aspiration or dysfunction., A 3-year-old child with suspected swallowing difficulties undergoes 74230 to assess their swallowing mechanism and guide appropriate feeding strategies. , A patient with head and neck cancer undergoes a modified barium swallow study (74230) following radiation therapy to evaluate the impact of treatment on their swallowing function.
Documentation should include the reason for the study, relevant medical history, the type and amount of contrast material used, a description of the swallowing process observed, and the provider's interpretation of the findings.
** Providers may refer to 74230 as a modified barium swallow. For this service, the radiologic provider may work with a speech-language pathologist, who would report 92611.
- Revenue Code: I1D - STANDARD IMAGING - CONTRAST GASTROINTESTINAL
- Modifier TC rule: Yes, under specific circumstances when billing for the technical component only.
- Specialties:Radiology, Otolaryngology, Speech-Language Pathology
- Place of Service:Office, On Campus-Outpatient Hospital,Off Campus-Outpatient Hospital, Independent Clinic,Federally Qualified Health Center