Billing and Coding Information
New CPT Codes for 2011
There are new and revised codes for esophageal motility, colon motility and wireless capsule GI tract transit and pressure measurement. These include changes to the descriptor of the esophageal motility code (91010); an add-on code to report esophageal motility with stimulation or perfusion (+91013 replaces codes 91011, 91012); two new category III codes for reporting high resolution esophageal pressure topography (HREPT) without (0240T) and with stimulation or perfusion (+0241T); a new category III code for reporting wireless capsule GI tract transit and pressure measurement (0240T); and a new code for reporting colon motility (91117).
Code 91117 is reported in addition to the endoscopic or radiologic procedure used to place the colon motility catheter. Colon motility testing must be for a minimum of six hours continuous reporting. Do not report multiple units of 91117 if testing lasts >24 hours.
| Esophageal Motility | |
|---|---|
| 91010 | Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; 2-dimensional data (91011, 91012 have been deleted. To report esophageal motility studies with stimulant or perfusion, use 91013) |
| +91013 | With stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (List separately in addition to code for primary procedure). (Use 91013 in conjunction with 91010) (Do not report 91013 more than once per session) |
| 0240T | Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with 3-dimensional high resolution esophageal pressure topography (Do not report 0240T in conjunction with 91010.) |
| 0241T | With stimulation or perfusion during 3-dimensional high resolution esophageal pressure topography study (eg, stimulant, acid or alkali perfusion) (List separately in addition to code for primary procedure) (Use 0241T in conjunction with 0240T) (Do not report 0241T in conjunction with 91010) (To report esophageal motility studies with 2-dimensional data, use 91010 and with stimulation or perfusion use, 91013) |
| Colon Motility | |
|---|---|
| 91117 | Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report (For wireless capsule pressure measurements, use 0242T) (Do not report 91117 in conjunction with 91120, 91122) |
| Wireless Capsule GI Tract Transit and Pressure Measurement | |
|---|---|
| 0242T | Gastrointestinal tract transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report. (Do not report 0242T in conjunction with 91020, 91022) |
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.
