Correct coding for single contrast small bowel follow-through imaging

Q.

We performed a single contrast small bowel follow-through which we coded as CPT^® code 74248. Insurance denied asking for a primary code. What other CPT code should we be using?

A.

CPT 74248 is designated as an add-on code to the upper gastrointestinal (UGI) imaging codes 74240 or 74246 when a small bowel follow-through is also performed.

When small bowel imaging is performed without a UGI, then report either primary CPT code 74250 or 74251. The CPT codes and full descriptions are:

74250 Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study

74251 Radiologic examination, 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