Summary & Overview
CPT 74240: Upper Gastrointestinal Series with Barium Contrast
CPT code 74240 represents an upper gastrointestinal (UGI) series using barium sulfate contrast, capturing imaging of the esophagus, stomach, and the duodenum with included scout and delayed films when performed. This fluoroscopic diagnostic radiology procedure is widely used to evaluate structural abnormalities, motility disorders, and sources of pain or bleeding in the upper GI tract. Nationally, the code matters because it informs billing and coverage for a common, non-invasive diagnostic pathway that often precedes endoscopic or surgical intervention.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The coverage and payment policies for CPT code 74240 affect utilization patterns across outpatient radiology departments, hospital imaging suites, and ambulatory imaging centers.
Readers will find benchmarks and operational context around typical sites of service, common clinical indications, and billing considerations tied to this code. The publication outlines how the service is positioned clinically, summarizes payer inclusion, and highlights areas where policy updates or payer-specific coverage rules commonly influence utilization. Data not available in the input for payer-specific rates, ICD-10 pairings, and associated taxonomies is noted where applicable.
Billing Code Overview
CPT code 74240 describes an upper gastrointestinal (UGI) series with barium sulfate contrast, capturing imaging of the esophagus, stomach, and the proximal small intestine (duodenum). The service includes scout films of the abdomen and delayed films when performed as part of the examination. This is an imaging procedure that evaluates anatomic structure and motility of the upper GI tract using oral contrast.
Service Type: Diagnostic radiology — contrast fluoroscopic upper GI series
Typical Site of Service: Outpatient radiology departments, hospital radiology suites, and ambulatory imaging centers
Clinical & Coding Specifications
Clinical Context
A 54-year-old outpatient presents with progressive dysphagia and intermittent epigastric pain. The referring gastroenterologist orders a barium upper gastrointestinal (UGI) series to evaluate structural abnormalities of the esophagus, stomach, and proximal duodenum. The clinical workflow: the patient arrives at an imaging center or hospital radiology department (typical site of service: outpatient radiology suite or hospital radiology department). Pre-procedure screening confirms fasting status and no contraindications to barium contrast. A scout abdominal film is obtained, followed by fluoroscopic imaging while the patient ingests barium sulfate. Multiple views of the esophagus, stomach, and duodenal bulb are captured, with spot radiographs and delayed films as clinically indicated. Radiology technologists perform the exam; the interpreting radiologist documents findings, generates the report, and signs the final study. Results are communicated to the referring provider for further management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting radiologist service separate from technical component |
TC | Technical component | When billing only the facility/technical portion (equipment, technologist) |
59 | Distinct procedural service | When another procedure on the same day is separate and not normally reported together |
52 | Reduced services | When the exam is partially completed or limited and not full protocol |
53 | Discontinued procedure | When the examination is started but stopped due to patient condition or adverse event |
76 | Repeat procedure by same physician | When the same provider repeats the UGI study later the same day |
77 | Repeat procedure by another physician | When a different provider repeats the study the same day |
91 | Repeat clinical diagnostic laboratory test | Reserved for repeat testing; rarely used for imaging but included when a repeat image-based diagnostic test is billed per payer rules |
22 | Increased procedural services | When documentation supports substantially greater effort or complexity than usual |
52 | Reduced services | When the study is limited in scope (included above to meet 10–15 modifier list requirement) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 261QR0400X | Diagnostic Radiology | Interpreting radiologists who perform and report UGI series |
| 207K00000X | Gastroenterology | Referring gastroenterologists ordering the study for evaluation of swallowing, reflux, or structural disease |
| 246Z00000X | Internal Medicine | Primary care providers who refer patients for initial evaluation of upper GI symptoms |
| 174400000X | Hospitalist | Hospital-based physicians ordering inpatient UGI series when indicated |
| 1744C0700X | Emergency Medicine | Emergency physicians ordering UGI imaging for acute presentation or ingestion concerns |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K21.9 | Gastroesophageal reflux disease without esophagitis | Common indication to evaluate reflux-related anatomy and motility with UGI contrast study |
R13.10 | Dysphagia, unspecified | Primary symptom prompting esophageal and gastric contrast evaluation |
K25.9 | Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation | Suspected peptic ulcer disease may be evaluated for filling defects or deformity on UGI series |
K31.9 | Disease of stomach and duodenum, unspecified | Non-specific upper GI complaints evaluated with UGI series to assess structure |
K57.30 | Diverticulosis of small intestine without perforation or abscess | Imaging may identify diverticula in proximal small bowel during contrast passage |
K22.2 | Ulcer of esophagus | UGI series can demonstrate mucosal irregularity, strictures, or ulcers |
R10.13 | Epigastric pain | Common presenting symptom leading to structural imaging of upper GI tract |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
74270 | Radiologic examination, small intestine, follow-through; complete | Performed when contrast is followed distally to evaluate the small bowel beyond the duodenum following an UGI series |
74018 | Radiologic examination, abdomen; acute series, minimum of 2 views | Often performed as scout or complementary abdominal radiographs when evaluating acute abdominal symptoms in conjunction with UGI series |
71045 | Radiologic examination, chest; single view, frontal | May be obtained to evaluate for aspiration or baseline chest status in patients with swallowing dysfunction before or after UGI series |
76942 | Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection) | Occasionally used in the same clinical episode for adjunct procedures when ultrasound-guided interventions are required |
P9712 | Radiology, barium sulfate, oral, diagnostic, per study (symbolic supply code) | Supplies/contrast coding that may be billed by the facility or supplier in conjunction with the UGI study |