Summary & Overview
CPT 74355: Imaging Supervision and Interpretation for Small Intestine Tube Placement
CPT code 74355 designates the imaging supervision and interpretation component for placement of an abdominal tube to allow imaging of the small intestine, such as under fluoroscopy. The code is used to bill for the physician or other qualified imaging professional’s oversight of the procedure and formal interpretation of the images, separate from the technical or procedural services. Nationally, this distinction matters for accurate allocation of professional imaging payment, documentation of medically necessary imaging interpretation, and correct claims processing.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical site of service, and the professional component it represents. The publication summarizes common modifiers and billing considerations, outlines typical payer coverage patterns, and highlights coding nuances relevant to imaging supervision and interpretation. It also points to related procedure and technical-service billing distinctions that influence how this service is reimbursed and documented. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes is noted as such, and readers are guided to verify payer-specific rules and documentation requirements when applying CPT code 74355.
Billing Code Overview
CPT code 74355 describes imaging supervision and interpretation performed for the separately reportable placement of a tube through the abdomen to enable imaging of the small intestine (for example, under fluoroscopy). The code represents only the imaging professional component — supervision of the imaging procedure and interpretation of the resulting images — and does not include the technical component or the procedural work of tube placement itself.
Service type: Imaging supervision and interpretation
Typical site of service: Hospital radiology suite or outpatient imaging center, where fluoroscopic guidance and image interpretation are available for interventional tube placement procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic or recurrent small-bowel obstruction, suspected enteric fistula, or severe malabsorption requiring direct small-bowel contrast studies. The patient is admitted to the hospital or presents to an outpatient interventional radiology or fluoroscopy suite after referral from gastroenterology or surgery. Prior to the procedure, informed consent and relevant labs (coagulation profile) are reviewed. Under sterile conditions and image guidance, an enteric tube (e.g., nasojejunal or surgically placed percutaneous enteric tube) is positioned through the abdomen for contrast administration to opacify the small intestine. The radiologist provides real-time fluoroscopic supervision and performs image interpretation. Documentation includes indication, technique, contrast used, images obtained, findings (such as obstruction level, leak, or motility abnormality), and recommendations. Billing for the imaging supervision and interpretation component is reported with 74355, and the actual tube placement procedure is reported separately by the performing proceduralist when applicable. Typical sites of service are the hospital inpatient unit, hospital outpatient radiology/interventional suite, or freestanding outpatient imaging center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/supervision portion of an imaging service separate from technical resources |