Summary & Overview
CPT 74235: Imaging Supervision and Interpretation for Esophageal Foreign Body Removal
CPT code 74235 designates the imaging supervision and interpretation component for fluoroscopically guided removal of an esophageal foreign body using a balloon catheter. The code is used to report only the radiologic service that accompanies a separately reported procedural removal. Nationally, clear reporting of imaging-only codes like 74235 matters for accurate claims processing, separating professional imaging services from procedural or operative services, and ensuring correct allocation of reimbursement between providers and facilities.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for use of 74235, the typical sites of service where the imaging component is provided, and how the code fits into the service line for foreign body removal procedures. The publication also summarizes common modifiers associated with imaging and professional components, highlights coding boundaries (imaging-only vs. procedural reporting), and outlines what national stakeholders typically consider when reviewing claims that include this code.
This summary serves as a focused reference for billing, coding, and revenue cycle professionals seeking concise guidance on when to report CPT code 74235 and what information to expect in payer coverage and claims workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 74235 represents imaging supervision and interpretation performed in support of a separately reportable procedure that removes a foreign body from the esophagus using a balloon catheter. This code is reported only for the imaging component of that procedure and does not include the endoscopic or surgical removal service itself.
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Service type: Imaging supervision and interpretation for fluoroscopic-guided foreign body removal using a balloon catheter
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Typical site of service: Hospital outpatient department or ambulatory surgical center where fluoroscopic guidance is available
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient who presents to the emergency department or endoscopy suite with an acute history of foreign body ingestion and radiographic evidence of an object lodged in the esophagus. The gastroenterology or otolaryngology team plans endoscopic removal using a balloon catheter technique (e.g., Foley or specialized retrieval balloon) performed by an endoscopist. A radiologist or fluoroscopy-qualified physician provides real-time imaging supervision and interpretation to guide balloon placement and confirm successful removal. The workflow includes triage and history, plain radiographs or fluoroscopic localization, informed consent, procedural sedation or anesthesia provided by anesthesia team if required, fluoroscopic imaging during balloon catheter advancement and inflation, documentation of images and interpretation, and a post-procedure radiographic confirmation as indicated. The imaging-only component for supervision and interpretation is reported separately using 74235 when the procedural removal is billed by the endoscopist as a separately reportable service.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician component for imaging supervision and interpretation. |