Motion fluoroscopic evaluation of swallowing function by cine or video recording
CPT4 code
Name of the Procedure:
Motion Fluoroscopic Evaluation of Swallowing Function by Cine or Video Recording (also known as Videofluoroscopic Swallowing Study or VFSS)
Summary
The motion fluoroscopic evaluation of swallowing function, or videofluoroscopic swallowing study (VFSS), is a diagnostic procedure that uses real-time X-ray technology to assess how well a person swallows. The test captures video recordings of the swallowing process, providing detailed images of the mouth, throat, and esophagus.
Purpose
This procedure is used to diagnose swallowing difficulties (dysphagia) and to identify the specific part of the swallowing process where the problem occurs. The goals are to determine the cause of swallowing difficulties, to assess the risk of aspiration (food or liquid entering the airway), and to guide treatment and dietary adjustments.
Indications
- Persistent swallowing difficulties (dysphagia)
- Coughing or choking during eating or drinking
- Unexplained weight loss or dehydration
- Frequent respiratory infections (which may suggest aspiration)
- Conditions such as stroke, neurological disorders, or head and neck cancers affecting swallowing
Preparation
- Patients are typically asked not to eat or drink for several hours before the procedure.
- Certain medications may need to be adjusted or temporarily discontinued.
- A thorough medical history and physical examination will be conducted.
Procedure Description
- The patient will be seated or positioned upright facing the fluoroscopy machine.
- Various types of foods and liquids, each mixed with barium (a contrast material that makes them visible on X-rays), will be given to the patient.
- The patient will swallow these substances under the observation of the fluoroscopy machine.
- The radiologist and speech-language pathologist will record videos and images of the swallowing process from different angles.
- The patient's swallowing function will be assessed in real-time, and recordings will be analyzed for any abnormalities.
Duration
The procedure typically takes about 30 to 45 minutes.
Setting
The procedure is usually performed in a hospital radiology department or an outpatient imaging center equipped with fluoroscopy technology.
Personnel
- Radiologist
- Speech-Language Pathologist
- Radiologic Technologist
- Nursing staff, if sedation or special care is required
Risks and Complications
- Exposure to a small amount of radiation
- Potential for minor discomfort or gagging when swallowing barium mixtures
- Rare risk of aspiration of contrast materials
Benefits
- Provides a detailed assessment of swallowing function
- Helps diagnose the cause of dysphagia
- Guides the development of a treatment plan, including dietary modifications and therapeutic exercises
- Minimizes the risk of complications like aspiration pneumonia
Recovery
- No specific post-procedure care is usually required.
- Patients can typically resume normal eating and drinking shortly after the procedure, unless otherwise advised.
- Mild constipation may occur due to barium; increasing fluid intake can help.
Alternatives
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES): Uses a flexible scope to visualize swallowing; does not involve radiation.
- Clinical Swallowing Evaluation: Observe and assess swallowing without imaging.
- Both alternatives have their pros and cons but may not provide the same detailed imaging as VFSS.
Patient Experience
- Patients may feel some discomfort from having to swallow different textures and flavors of barium mixtures.
- The procedure is generally well-tolerated, and any discomfort is usually temporary.
- If any sensation of food being stuck or residual throat pain persists, patients should inform the healthcare provider.