Radiological tests are an integral part of Gastroenterology care. CPT codes 74240 and 74246 are used for radiologic examination of the upper gastrointestinal (GI) tract. These codes differ significantly in terms of the scope of the procedure. Following is an explanation for both codes.
What is CPT Code 74240?
CPT code 74240 is the testing code for radiologic examination of the upper gastrointestinal tract, including the esophagus, stomach, and duodenum. This procedure is performed without the use of KUB (kidney, ureter, bladder) fluoroscopy and often includes the administration of a contrast medium to allow better visualization of these areas. This procedure captures images as the contrast medium moves through the GI tract, helping to assess conditions like ulcers, tumors, or anatomical abnormalities.
Key Points of CPT Code 74240
- Used for a standard examination of the upper GI tract.
- Focuses on the esophagus, stomach, and duodenum.
- Does not include a small intestine examination.
- Used when basic visualization is needed.
- A contrast medium may be used without extensive fluoroscopy beyond the basic requirements.
What is CPT Code 74246?
CPT code 74246 is for extended upper gastrointestinal radiologic examination. This code includes all the components of CPT 74240 but adds fluoroscopy for a more detailed assessment. The fluoroscopy component allows for continuous imaging, making it easier to assess the dynamics of swallowing and digestion and to better visualize any abnormalities in the upper GI tract.
Key Points for CPT Code 74246
- A comprehensive examination of the upper GI tract.
- Includes fluoroscopy to provide real-time imaging of the digestive process.
- Used when a more detailed evaluation is necessary.
- Useful for identifying complex conditions or abnormalities that may require continuous monitoring as the contrast medium flows through the GI tract.
- Often includes both static and dynamic images for in-depth analysis.
Key Differences Between CPT 74240 and 74246
Here are some key differences between CPT code 74240 and 74246:
| Entity | CPT Code 74240 | CPT Code 74246 |
| Procedure Type | Basic upper GI radiologic examination | Extended upper GI radiologic examination |
| Fluoroscopy | Not included | Included for real-time imaging |
| Contrast Medium | Basic application | Comprehensive application with real-time tracking |
| Use Case | Standard GI visualization | In-depth, dynamic evaluation |
| Ideal for | Basic visualization needs | Detailed study of digestive processes |
At a Glance
- CPT 74240 – for patients needing a standard radiologic evaluation of the upper GI tract, where simple visualization of the esophagus, stomach, and duodenum is sufficient.
- CPT 74246 – when a detailed, dynamic study is required, often in cases where symptoms or findings are suggesting complex GI issues, such as motility disorders, reflux, or detailed assessment of esophageal function.
Final Thoughts
Selecting CPT 74240 or 74246 is only the first step in the billing process. The claim still depends on complete documentation, medical necessity, payer-specific coverage policies, and accurate diagnosis coding to support reimbursement. FC Billing provides Medical Billing Services for Gastroenterologist that help GI practices manage these requirements while reducing denials and improving payment accuracy.
