Summary & Overview
CPT 74246: Upper GI Fluoroscopy with Air and High‑Density Barium
CPT code 74246 designates a fluoroscopic double‑contrast upper gastrointestinal (GI) series using both air and high‑density barium to evaluate the esophagus, stomach, and duodenum; glucagon may be administered to reduce spasms. This imaging code is widely used in diagnostic radiology for patients with suspected structural or motility abnormalities of the upper GI tract and remains important for national quality measurement and claims processing due to its diagnostic role and frequent use in outpatient settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides readers with national benchmarks for utilization and reimbursement patterns where available, summarizes relevant policy or coverage clarifications from major payers, and situates the code within clinical practice by describing the typical indications and site‑of‑service considerations. Readers will learn how CPT code 74246 is applied in clinical workflows, common billing contexts, and which settings typically perform the service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 74246 describes a fluoroscopic upper gastrointestinal (GI) series performed with both air (double contrast) and high‑density barium to evaluate the esophagus, stomach, and duodenum. The procedure may include administration of glucagon to reduce GI tract spasms for improved imaging.
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Service type: Diagnostic imaging study of the upper GI tract using fluoroscopy with double‑contrast barium technique.
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Typical site of service: Radiology departments, hospital outpatient imaging centers, and freestanding imaging facilities where fluoroscopic studies are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old female with a three-month history of progressive dysphagia, intermittent epigastric pain, and unintentional weight loss is referred for an upper GI fluoroscopic examination with both air and high-density barium contrast (74246). The study is performed in an outpatient radiology department. The patient is screened for contraindications to contrast; glucagon is available and administered intravenously to reduce gastric and esophageal spasm when needed. The technologist positions the patient and assists during fluoroscopic imaging while the radiologist performs real-time interpretation, evaluating the esophagus, stomach, and duodenum for mucosal irregularity, strictures, hiatal hernia, gastric outlet obstruction, and motility disorders. Images and video loops are archived; a formal report is generated documenting findings and recommendations for further management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When only the interpreting physician’s services are billed separately from the facility technical component |
52 | Reduced services |