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This section provides information about ordering VARIBAR, including a calculator to help you estimate your monthly needs; how to connect with your VARIBAR sales representative; and reimbursement support, your one-stop resource for coding and education.
Estimating Your VARIBAR® (barium sulfate) needs…
This calculator is provided to help you estimate your monthly product needs. It is not intended to suggest you order just 1 month of product at a time. Different product distributors may have different product order minimums and case sizes. Contact your distributor or your VARIBAR sales representative if you have questions.
Enter your number of Modified Barium Swallow Studies (MBSS) performed per week:
Cannisters of VARIBAR® THIN LIQUID (barium sulfate) for oral suspension*
(SKU 900001 NDC 32909-105-10)
cannisters per month
Bottles of VARIBAR® NECTAR (barium sulfate) oral suspension
(SKU 705700 NDC 32909-116-00)
bottles per month
Bottles of VARIBAR® THIN HONEY (barium sulfate) oral suspension
(SKU 900004 NDC 32909-121-07)
bottles per month
Bottles of VARIBAR® HONEY (barium sulfate) oral suspension
(SKU 900005 NDC 32909-122-07)
bottles per month
Tubes of VARIBAR® PUDDING (barium sulfate) oral paste
(SKU 900006 NDC 32909-125-22)
tubes per month
*VARIBAR Thin Liquid has a refrigerated shelf life of 72 hours after reconstitution, so you may want to order extra based on your scheduling patterns.
To Order, Click to Find a BRACCO VARIBAR Specialist Near You
Reimbursement Support Information
Your one-stop resource for coding, reimbursement support, and education.
VARIBAR® (barium sulfate), like all other barium contrast agents, does not have Level II HCPCS codes. Under Medicare, barium products are considered to be drugs used as supplies1 and are not separately billable or paid. Hospitals should follow CMS’ guidance for billing drugs that are packaged and paid as supplies—reporting coded and uncoded drugs with their charges under the revenue code associated with the cost center under which the hospital accumulates the costs for the drugs.
Check with your chargemaster specialist—common revenue codes for barium contrast agents are:2
| 0255 | drugs incident to radiology |
|---|---|
| 0270 | medical/surgical supplies—general or |
| 0621 | medical/surgical supplies — extension of 027X — incident to radiology |
Commercial payors may or may not reimburse for barium products separately. Please check with your individual payor’s plans.
1. Medicare Benefit Policy Manual, Chapter 15—Covered Medical and Other Health Services, Section 50.2.M
2. Hospital Revenue Codes, Noridian https://med.noridianmedicare.com/web/jea/topics/claim-submission/revenue-codes — accessed November 20, 2023
Disclaimers
The information provided is general reimbursement information for Bracco products. It is not legal advice, nor is it advice about how to code, complete or submit any particular claim for payment. Although we supply this information based on our current knowledge, it is always the provider’s responsibility to determine and submit appropriate codes, charges, modifiers and bills for services that were rendered. This coding and reimbursement information is subject to change without notice. Payers or their local branches may have their own coding and reimbursement requirements and policies. Before filing any claims, providers should verify current requirements and policies with the payer.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
IMPORTANT SAFETY INFORMATION:
For Oral Administration. This product should not be used in patients with known or suspected perforation of the GI tract, known obstruction of the GI tract, high risk of aspiration, or hypersensitivity to barium sulfate products. Rarely, severe allergic reactions of anaphylactoid nature have been reported following administration of barium sulfate contrast agents. Aspiration may occur during the modified barium swallow examination, monitor the patient for aspiration.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
INDICATIONS
VARIBAR® THIN HONEY (barium sulfate) oral suspension, VARIBAR® NECTAR (barium sulfate) oral suspension, and VARIBAR® THIN LIQUID (barium sulfate) oral suspension are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients.
VARIBAR® HONEY (barium sulfate) oral suspension and VARIBAR® PUDDING (barium sulfate) oral paste are radiographic contrast agents indicated for use in modified barium swallow examinations to evaluate the oral and pharyngeal function and morphology in adult and pediatric patients 6 months of age and older.
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
These products should not be used in patients with known or suspected perforation of the gastrointestinal (GI) tract; known obstruction of the GI tract; high risk of GI perforation such as those with a recent GI perforation, acute GI hemorrhage or ischemia, toxic megacolon, severe ileus, post GI surgery or biopsy, acute GI injury or burn, or recent radiotherapy to the pelvis; high risk of aspiration such as those with known or suspected tracheo-esophageal fistula or obtundation; known severe hypersensitivity to barium sulfate or any of the excipients of the product used.
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions
Barium sulfate preparations contain a number of excipients, including natural and artificial flavors, and may induce serious hypersensitivity reactions. The manifestations include hypotension, bronchospasm and other respiratory impairments, and dermal reactions including rashes, urticaria, and itching. A history of bronchial asthma, atopy, food allergies, or a previous reaction to a contrast agent may increase the risk for hypersensitivity reactions. Emergency equipment and trained personnel should be immediately available for treatment of a hypersensitivity reaction.
Intra-abdominal Barium Leakage
The use of VARIBAR PRODUCTS is contraindicated in patients at high risk of perforation of the GI tract. Administration of VARIBAR PRODUCTS may result in leakage of barium from the GI tract in the presence of conditions such as carcinomas, GI fistula, inflammatory bowel disease, gastric or duodenal ulcer, appendicitis, or diverticulitis, and in patients with a severe stenosis at any level of the GI tract, especially if it is distal to the stomach. The barium leakage has been associated with peritonitis and granuloma formation.
Delayed Gastrointestinal Transit and Obstruction
Orally administered barium sulfate may accumulate proximal to a constricting lesion of the colon, causing obstruction or impaction with development of baroliths (inspissated barium associated with feces) and may lead to abdominal pain, appendicitis, bowel obstruction, or rarely perforation. Patients with the following conditions are at higher risk for developing obstruction or baroliths: severe stenosis at any level of the GI tract, impaired GI motility, electrolyte imbalance, dehydration, on a low residue diet, taking medications that delay GI motility, constipation, pediatric patients with cystic fibrosis or Hirschsprung disease, and the elderly. To reduce the risk of delayed GI transit and obstruction, patients should maintain adequate hydration after the barium sulfate procedure. When administering VARIBAR PUDDING, consider the administration of laxatives.
Aspiration Pneumonitis
The use of VARIBAR PRODUCTS is contraindicated in patients with trachea-esophageal fistula. Oral administration of barium is associated with aspiration pneumonitis, especially in patients with a history of food aspiration or with compromised swallowing mechanism. Vomiting following oral administration of barium sulfate may lead to aspiration pneumonitis. In patients at risk for aspiration, begin the procedure with a small ingested volume of VARIBAR PRODUCTS. Monitor the patient closely for aspiration, discontinue administration of VARIBAR PRODUCTS if aspiration is suspected, and monitor for development of aspiration pneumonitis.
Systemic Embolization
Barium sulfate products may occasionally intravasate into the venous drainage of the GI tract and enter the circulation as a "barium embolus" leading to potentially fatal complications which include systemic and pulmonary embolism, disseminated intravascular coagulation, septicemia and prolonged severe hypotension. Although this complication is exceedingly uncommon after oral administration of a barium sulfate suspension, monitor patients for potential intravasation when administering barium sulfate.
ADVERSE REACTIONS
The most common adverse reactions are nausea, vomiting, diarrhea, and abdominal cramping. Serious adverse reactions and fatalities include aspiration pneumonitis, barium sulfate impaction, intestinal perforation with consequent peritonitis and granuloma formation, vasovagal and syncopal episodes.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here for full Prescribing Information for VARIBAR® THIN LIQUID (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® THIN HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® NECTAR (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® HONEY (barium sulfate) oral suspension.
Please click here for full Prescribing Information for VARIBAR® PUDDING (barium sulfate) oral paste.
VARIBAR is manufactured by E-Z-EM Canada Inc., for E-Z-EM, Inc., a subsidiary of Bracco Diagnostics Inc., Princeton, NJ 08540.
VARIBAR is a registered trademark of E-Z-EM, Inc.
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
VARIBAR® (barium sulfate)
IMPORTANT SAFETY INFORMATION:
For Oral Administration. This product should not be used in patients with known or suspected perforation of the GI tract, known obstruction of the GI tract, high risk of aspiration, or hypersensitivity to barium sulfate products. Rarely, severe allergic reactions of anaphylactoid nature have been reported following administration of barium sulfate contrast agents. Aspiration may occur during the modified barium swallow examination, monitor the patient for aspiration.