Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study
CPT4 code
Name of the Procedure:
Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (e.g., barium) study.
Summary
This procedure involves taking X-ray images of the colon after filling it with a special dye called barium. Barium is a contrast material that helps to highlight the colon on X-ray images, allowing doctors to look for any abnormalities.
Purpose
The primary goal of this procedure is to diagnose and evaluate abnormalities in the colon such as blockages, diverticula, polyps, tumors, or inflammatory conditions. By using a single-contrast barium study, doctors can get clear images to help determine the cause of symptoms like abdominal pain, blood in the stool, or changes in bowel habits.
Indications
- Unexplained abdominal pain
- Gastrointestinal bleeding
- Chronic diarrhea or constipation
- Unexplained weight loss
- Changes in bowel habits
- Suspected inflammatory bowel disease
- Screening for colon cancer
Preparation
- Fasting: The patient may be instructed not to eat or drink anything for several hours prior to the procedure.
- Bowel preparation: Patients may need to take a laxative or undergo an enema the day before to clear the bowels.
- Medications: Certain medications may need to be adjusted or temporarily stopped.
- Diagnostic tests: Blood tests or other imaging studies may be required beforehand.
Procedure Description
- The patient lies on an X-ray table in various positions.
- A preliminary "scout" abdominal radiograph may be taken to ensure the bowel is clear.
- A lubricated, flexible tube is gently inserted into the rectum to deliver the barium contrast.
- Barium is slowly introduced into the colon while the patient is repositioned to coat the lining thoroughly.
- Several X-ray images are taken in different positions.
- Delayed images might be taken to observe how the barium moves through the colon.
- Once images are complete, the tube is removed, and the patient is allowed to empty the bowel.
Tools: X-ray machine, barium contrast, and flexible enema tube. Anesthesia/Sedation: Typically not required, but mild sedation may be used in certain cases.
Duration
The procedure generally takes about 30 to 60 minutes.
Setting
The procedure is performed in a radiology department, usually within a hospital or an outpatient clinic.
Personnel
- Radiologist: Performs and interprets the X-ray images.
- Radiologic Technologist: Assists with the procedure and operates the X-ray equipment.
- Nurse or Medical Assistant: Provides support and patient care.
Risks and Complications
- Common risks: Discomfort, bloating, cramping.
- Rare risks: Perforation of the bowel, allergic reaction to barium, bowel obstruction.
- Management: Complications are handled with appropriate medical or surgical interventions as needed.
Benefits
- Accurate diagnosis of colon conditions.
- Non-invasive compared to surgical options.
- Results can often be interpreted immediately.
Recovery
- Post-procedure care: Patients may resume normal diet and activities after the procedure.
- Drink plenty of fluids to help flush out the barium.
- Mild cramping or changes in stool color (white or light) may occur for a few days.
- Follow-up: If abnormal findings are detected, further tests or treatments might be needed based on doctor's recommendations.
Alternatives
- Colonoscopy: More invasive but provides a direct visual of the colon and allows for biopsies.
- CT colonography: A virtual imaging technique offering a 3D view.
- Stool tests: Less invasive but may not be as thorough.
- Each alternative has its own set of benefits and limitations in terms of accuracy, invasiveness, preparation, and recovery.
Patient Experience
- During the procedure: The patient may feel discomfort, pressure, or mild cramping.
- After the procedure: Some cramping and changes in stool color are expected; any severe pain or symptoms should be reported to a healthcare provider.
- Pain management: Over-the-counter pain relievers and hydration are generally sufficient for managing minor discomfort.