Download Upper Gastrointestinal (GI) Series

Upper Gastrointestinal (GI) Series
Date: _____________ Time: _____________ Check-in: _____________
700 Ironwood Drive, Suite 175
Coeur d’Alene, Idaho 83814
208.625.6300 tel
What is an Upper GI Series?
An upper GI series is an X-ray examination of your upper gastrointestinal tract, including the esophagus, stomach and part of
the small intestine.
Why is it Performed?
This procedure may be performed if a patient is experiencing frequent heartburn or stomach pain, or if your doctor suspects an
ulcer or blockage. Other reasons may include diarrhea, unusual weight loss, difficulty swallowing, regurgitation (reflux), rectal
bleeding, blood in stools, or vomiting blood.
How is it Performed?
The examination takes about an hour, including prep time.
You will either be asked to stand at the end of an erect X-ray table or to lie down on a tilting table attached to a fluoroscope,
which is an X-ray unit, combined with a television screen. You may be asked to swallow baking-soda granules to help put air
(gas) into your stomach. The radiologist will give you a liquid barium milkshake to drink which allows the radiologist to see your
organs in greater detail.
How to Prepare
For the examination to be successful, your stomach and upper GI tract must be completely empty. You will be asked not to
eat or drink anything after midnight the night before the exam. You should also not chew gum or smoke as these activities can
increase stomach secretions which may affect test results. Be sure to inform your physician of any medications you are taking,
allergies, all recent illnesses or other medical conditions, or if you may be pregnant.
Insurance & Billing Information
Kootenai Outpatient Imaging patients will receive two statements, one for technical services from Kootenai Health and the other
for radiologist interpretation from Kootenai Imaging.
Billing Questions?
Kootenai Health customer service: 208.625.6199 or 888.974.1235 toll free • kh.org and click on Pay My Bill Online
Kootenai Imaging customer service: 877.318.7270 • peryourhealth.com
Insurance plans may require a referral, deductible, co-payment or preauthorization. It is the patient’s responsibility to be aware
of these requirements. Your insurance contract is between you, your employer and your insurance carrier. Please contact
your insurance carrier with questions on your specific coverage. All domestic insurance carriers will be billed. Patients with
contracted insurance carriers may benefit from a contractual rate adjustment.
Submitting Your Payment
Payments for Kootenai Health can be made:
• In person: 1221 W. Ironwood Drive, Coeur d’Alene, ID 83814, M-F, 7:30 a.m. – 4:30 p.m.
•
By mail: Kootenai Outpatient Imaging, 2003 Kootenai Health Way, Coeur d’Alene, ID 83814
•
By phone: 208.625.6199 or 888.974.1235 toll free M-F, 7:30 a.m. – 4:30 p.m.
•
Online: Visit www.kh.org and click on Pay My Bill Online
Coeur d’Alene, ID
AmeriTel
Inn
Shopko
Shari’s
Wells
Fargo
Albertsons
U.S. 95 (Lincoln Way)
Kootenai Health Way
Exit 12
McGrane
Center
Health
Resource
Center
Imaging
Services
Parking
Garage
Ironwood
Dr.
90
Lakew
ood D
r.
Exit 11
Northw
est Blv
d.
Ironwood Dr.
1919
Lincoln
Way
Kootenai
Outpatient
Imaging