Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study
CPT4 code
Name of the Procedure:
Radiologic Examination of the Pharynx and/or Cervical Esophagus (Contrast Study with Barium)
Summary
A radiologic examination of the pharynx and cervical esophagus involves taking X-ray images of the throat and upper esophagus using a contrast material, typically barium, to enhance the visibility of these structures. The procedure also includes preliminary images of the neck ("scout" radiographs) and delayed imaging as needed.
Purpose
This procedure is designed to evaluate the structure and function of the pharynx and cervical esophagus. It helps diagnose conditions such as blockages, structural abnormalities, tumors, swallowing difficulties, or other esophageal disorders.
Indications
- Difficulty swallowing (dysphagia)
- Suspected structural abnormalities (e.g., strictures or diverticula)
- Chronic throat discomfort or pain
- Evaluation of masses or tumors
- Follow-up on previous esophageal surgery
- Hoarseness or chronic cough potentially related to esophageal issues
Preparation
- Patients may be instructed to fast for several hours before the procedure.
- Inform your healthcare provider of any medications you are taking; some may need to be paused.
- Diagnostic tests such as preliminary blood work may be required.
Procedure Description
- Scout Radiographs: Initial X-ray images of the neck are taken to plan the procedure.
- Administration of Barium: The patient swallows a barium solution, which coats the lining of the pharynx and esophagus, making them visible on X-ray.
- Imaging: A series of X-rays are taken while the patient swallows the barium. The radiologist may take images from various angles.
- Delayed Images: Additional X-rays may be taken after some time to monitor the movement of the barium through the esophagus.
This typically does not involve anesthesia or sedation.
Duration
The procedure usually takes about 30 minutes to 1 hour.
Setting
The procedure is performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist (a doctor specializing in imaging)
- Radiologic technologist
- Nurse or medical assistant (if needed)
Risks and Complications
- Exposure to a low level of radiation
- Possible allergic reaction to the barium (very rare)
- Risk of aspiration if the patient has severe swallowing difficulties
- Constipation from barium
Benefits
- Provides detailed images of the pharynx and cervical esophagus.
- Helps accurately diagnose and guide treatment for esophageal conditions.
- Non-invasive with a relatively quick recovery time.
Recovery
- Patients might experience mild constipation or abdominal discomfort after the procedure.
- Drinking plenty of fluids can help clear the barium from the system.
- Most patients can resume normal activities immediately.
- Follow-up appointments may be scheduled to discuss results.
Alternatives
- Endoscopy: A more invasive procedure where a camera is used to view the esophagus.
- CT or MRI scans: Alternative imaging methods without barium.
- Ultrasound: Non-invasive but typically less detailed for this area.
Patient Experience
- During the procedure, patients might feel discomfort from swallowing the barium solution.
- Afterward, there may be a chalky taste in the mouth.
- Pain is typically minimal, and any discomfort usually resolves quickly.
- The healthcare team will provide comfort measures and answer any questions.