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2025 CPT code 74251

Radiologic examination of the small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (e.g., high-density barium and air via enteroclysis tube) study, including glucagon, when administered.

Code 74251 should not be reported with codes 74248 or 74250. Code 44500 or 74340 should be reported for the placement of the enteroclysis tube. Modifiers 26 and TC may be used depending on who performs the professional and technical components of the service.

Modifiers 26 (Professional Component), 52 (Reduced Services), 53 (Discontinued Procedure), 76 (Repeat Procedure or Service by Same Physician), 77 (Repeat Procedure by Another Physician), 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period), 80 (Assistant Surgeon), 81 (Minimum Assistant Surgeon), 82 (Assistant Surgeon (when qualified resident surgeon not available)), 99 (Multiple Modifiers), TC (Technical component) may be applicable.

Medical necessity for this procedure must be established by documenting the patient's symptoms, signs, and medical history that justify the need for imaging the small intestine.

IMPORTANT:(For placement of enteroclysis tube, see 44500, 74340)(Do not report 74251 in conjunction with 74248, 74250)

In simple words: This procedure uses X-rays to examine your small intestine. A tube is inserted through your nose or mouth and into your small intestine.A special dye (barium) and air are then introduced through the tube to improve the X-ray images. Multiple pictures are taken as the dye moves through your intestines.A medicine called glucagon may also be given to help relax the intestines.

This code represents a radiologic examination of the small intestine using a double-contrast method. It involves taking multiple serial images of the small intestine after administering high-density barium and air through an enteroclysis tube.A scout abdominal radiograph may also be taken before the contrast is instilled. The procedure may include the administration of glucagon. The enteroclysis tube is placed through the nose or mouth and advanced into the small intestine. The high-density barium coats the lining of the intestines, while the air expands the lumen for better visualization. Multiple X-rays are taken as the contrast flows through the bowel, and the flow is observed via fluoroscopy.

Example 1: A patient presents with abdominal pain and suspected Crohn's disease. An enteroclysis study is performed to evaluate the small intestine for inflammation or strictures., A patient has a history of small bowel obstruction. A double-contrast enteroclysis is ordered to assess the current state of the bowel and identify any potential blockages., A patient experiences chronic diarrhea and weight loss. The physician orders a small bowel enteroclysis to investigate the cause of these symptoms and rule out malabsorption or other intestinal disorders.

Documentation should include relevant clinical history, reason for the study, administration of contrast and glucagon (if given), technical details of the procedure, and interpretation of the findings. Images and a final report are also required.

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