Summary & Overview
CPT 74210: Contrast Study of Pharynx and Cervical Esophagus
CPT code 74210 represents a diagnostic radiologic contrast study of the pharynx and/or cervical esophagus, including scout and delayed images when performed. This fluoroscopic contrast examination is used to assess swallowing function and to detect structural or motility abnormalities in the upper esophageal region. Nationally, the code is important for imaging workflows, billing compliance, and quality measurement related to dysphagia and upper aerodigestive tract evaluation.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 74210, typical sites of service, and the common modifiers associated with imaging services. The publication outlines benchmarking and billing considerations relevant to payers listed above and highlights policy and documentation elements that affect coverage and claim adjudication. Content addresses expected components of the service, typical utilization scenarios, and items to verify for claims processing.
Data not available in the input is noted where applicable. The material is intended for national audiences including billing staff, radiology administrators, and payer policy analysts seeking a focused briefing on CPT code 74210.
Billing Code Overview
CPT code 74210 describes a radiological examination of the pharynx, the cervical esophagus, or both using contrast to enhance visualization. The procedure includes scout neck image(s) and delayed images when performed and is intended to evaluate swallowing, anatomic abnormalities, strictures, or other pathology of the pharynx and upper esophagus.
Service type: Diagnostic radiology — contrast study of the pharynx and cervical esophagus
Typical site of service: Imaging centers, hospital outpatient radiology departments, and outpatient clinics with fluoroscopy capabilities
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to the outpatient radiology department with progressive dysphagia to solids and intermittent aspiration during swallowing. The referring otolaryngologist requests a radiographic evaluation of the pharynx and cervical esophagus to evaluate for structural abnormalities, motility disorders, or aspiration risk. The patient is positioned upright for a contrast swallow study using barium (or water-soluble contrast if indicated), with scout neck images obtained first. Real-time fluoroscopic imaging captures oral, pharyngeal, and cervical esophageal phases; delayed images of the cervical esophagus are obtained as clinically warranted. The study is interpreted by the radiologist, who documents findings such as pooling, penetration/aspiration, diverticulum, stricture, or impaired motility. Images and a written report are transmitted to the referring provider. Typical site of service is an outpatient radiology suite, hospital radiology department, or ambulatory imaging center. Service type: diagnostic fluoroscopic contrast study of the pharynx and cervical esophagus (contrast swallow/modified barium swallow or esophagram limited to cervical esophagus).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting physician's component separate from technical services |