Common Medical Billing Coding Confusion

A common confusing coding dilemma concerns the diagnostic investigation of the swallowing function with a few different methods. The two codes that cause the most confusion are 70371 and 74230 and knowing when to use them will make the difference between a paid medical billing claim and a denial or delayed claim.

Here is a breakdown of the basics for the two codes :
70371: Code 70371 (Complex dynamic pharyngeal and speech evaluation by cineradiography or video recording) describes a radiologic study using cineradiography or video recording for pharyngeal and speech evaluation. Typically, although not necessarily, a speech pathologist is present, and the patient repeats sounds to allow for evaluation of the mouth and tongue during speech.

74230: The swallowing function exam described by 74230 (Swallowing function, with cineradiography/videoradiography) is also called a “modified barium swallow” and is used to evaluate the oropharynx, hypopharynx, and upper esophagus.

You will need to ascertain if the procedure was complex evaluation (use 70371) or it was an exam using barium 74230). In either event, you will need to document what events led up to the need for the exam whether complex or not. By filing your claim using the basis of the exam, it is much easier to round up your documentation to support your claim and then show the necessity for the exam.

Medical billing can seem confusing until you reduce the claim to the basics and then build it back up with your documentation – using this technique will ensure your claims get paid.

View all Articles by: Melissa Clark, CCS-P