Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study
CPT4 code
Name of the Procedure:
Radiologic examination of swallowing function with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), contrast (e.g., barium) study. Commonly referred to as a Barium Swallow Study or Modified Barium Swallow (MBS).
Summary
A Barium Swallow Study is an imaging test that evaluates how well a patient swallows liquids and solids. The procedure uses a special form of X-ray technology, known as cineradiography or videoradiography, to capture real-time video images of the throat and esophagus during swallowing.
Purpose
This procedure assesses swallowing difficulties (dysphagia) and helps identify abnormalities in the throat and esophagus. It aims to diagnose conditions like esophageal strictures, achalasia, structural abnormalities, and other swallowing disorders. Successful outcomes include an accurate diagnosis and a tailored treatment plan.
Indications
- Symptoms of difficulty swallowing (dysphagia)
- Unexplained weight loss
- Persistent cough or choking while eating
- Suspected aspiration (food or liquid entering the airway)
- Diagnosis and follow-up of known swallowing disorders
Preparation
- Patients may be instructed to fast (no eating or drinking) for about 4-6 hours before the procedure.
- Inform the healthcare provider of all medications being taken; some may need to be adjusted.
- Diagnostic tests such as a preliminary physical examination or a basic X-ray might be required.
Procedure Description
- The patient will be asked to change into a hospital gown.
- Initial "scout" neck radiographs are taken to provide a baseline image.
- The patient will be given a barium contrast liquid to drink. Barium is a substance that helps structures show up clearly on X-rays.
- As the patient swallows the barium, a series of X-ray images or continuous video (cineradiography/videoradiography) is taken in real-time.
- The procedure may include different consistencies of barium, such as thick liquids or barium-coated foods, to assess various aspects of the swallowing process.
- Delayed images may also be captured to observe slower or difficult swallows.
Duration
Typically, the procedure takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital radiology department or an outpatient imaging center.
Personnel
- Radiologist (specializes in imaging procedures)
- Speech-language pathologist (in cases where detailed swallowing assessment is needed)
- Radiologic technologist
Risks and Complications
- Exposure to a small amount of radiation
- Mild discomfort due to the taste and texture of barium contrast
Rare risks include allergic reactions to the barium contrast or aspiration (barium entering the lungs)
Benefits
- Provides detailed images to diagnose swallowing disorders accurately
- Helps in planning appropriate treatments and interventions
- Immediate visualization of swallowing mechanics for a real-time assessment
Recovery
- Patients can typically return to their normal activities immediately after the procedure.
- It is advisable to drink plenty of fluids to help eliminate the barium from the body, as it can cause constipation.
Alternatives
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES): Uses a small camera inserted through the nose to view swallowing.
- Esophagram: Another type of X-ray used to visualize the esophagus.
- Endoscopy: A procedure using a flexible tube with a camera to directly view the esophagus and stomach.
Patient Experience
- The patient might feel slight discomfort while drinking the barium.
- The taste and texture of the barium solution might be unpleasant.
- Some patients report a feeling of fullness or minor nausea.
- Pain management is typically not needed as the procedure is non-invasive and usually painless.