Billing and Coding Information
New CPT Codes for 2006
91022 Duodenal motility (manometric) study with the placement of a motility probe into the duodenum with its tip distal to the ligament of Treitz. Duodenal motility is generally measured in both fasting and fed states, and occasionally with and without prokinetic agents. This code is distinct from the existing code 91020 describing gastric motility - they can both be billed together if the test is measuring both - as is generally done with antroduodenal manometry. If an endoscopy is performed for tube placement, 43235 should be used, and if fluoroscopy is performed, 76000 should be used with 91022.
New CPT Codes for 2005
91034 Esophageal pH monitoring using nasal catheter pH electrode
(replaces 91032, 91033 starting January 2005)
91035 Esophageal pH monitoring using mucosal attached telemetry pH probe
(Bravo pH system) (replaces 91032, 91033 starting January 2005)
91037 Esophageal Function testing using gastroesophageal impedance for up to 1 hour
91038 Prolonged gastroesophageal impedance testing for > 1 hour and up to 24 hours
91040 Esophageal balloon distension provocation testing to evaluate patients with atypical chest pain
91120 Rectal balloon provocation to measure sensory, motor, and biochemical function of rectum in patients with IBS, constipation, and/or fecal incontinence.
43257 Upper endoscopy with delivery of thermal injury to LES (Stretta procedure)
91065 Breath hydrogen testing for lactose intolerance, has been modified to include testing for fructose intolerance, bacterial overgrowth, and evaluation of oro-cecal transit time
CPT Codes still in effect
91010 Esophageal manometry
91011 Esophageal manometry with stimulant (edrophonium)
91012 Esophageal manometry with acid perfusion (Bernstein testing)
91122 Anorectal manometry
90911 Biofeedback training during anal manometry and/or EMG
45391 Flexible sigmoidoscopy with endoscopic ultrasound
91132 Electrogastrography
91133 Electrogastrography with provocative testing (meals, stimulants)
43263 ERCP with sphincter of Oddi manometry
0008T Endoscopic suturing of the esophagogastric junction
91299 Unlisted diagnostic gastroenterologic procedure
Note: 26 modifier is for professional services component
TC modifier is for technical component
Updated information on Billing and Coding is provided in the ANMS Newsletter - The Recorder. This is sent out twice a year and is on this web site in the Membership section.
The ANMS committee on clinical practice headed by Satish Rao is working on developing new codes and better reimbursement for procedures.
In addition, the following ANMS-sponsored manuscript reviewed the topic of billing and coding for GI motility procedures.
Botoman VA, Rao S, Dunlap P, Abell T, Falk GW; Bill Coding and RVS Committee, American Neurogastroenterology and Motility Society. . Motility and GI function studies billing and coding guidelines: a position paper of the American Neurogastroenterology and Motility Society. American Journal of Gastroenterology 2003; 98(6):1228-36.
