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Billing and Procedure Codes

Billing and Procedure Codes

CPT Code Definition

Esophageal Function Testing

  • 91010: Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report
  • +91013: With stimulation or perfusion (e.g., stimulant, acid or alkali perfusion) (List separately in addition to code for primary procedure) (Use 91013 with 91010)
  • 91034: Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation
  • 91035: Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation
  • 91037: Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation
    91038: Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)
  • 91040: Esophageal balloon distension study, diagnostic, with provocation when performed

Colon and Anorectal Function Testing

  • 90901 Biofeedback training by any modality
  • 90912 (new for 2020): Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient
  • 90913 (new for 2020): Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately)
  • 91117: Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, e.g., meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report
  • 91120: Rectal sensation, tone, and compliance test (i.e., response to graded balloon distention)
  • 91122: Anorectal manometry
  • 95907-95913: Nerve conduction studies (depending on volume performed)
  • 97032: Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes
  • 76376: 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image post-processing under concurrent supervision; not requiring image post-processing on an independent workstation
  • 76872: Ultrasound, transrectal

Other GI Motility and Function Testing

  • 91022: Duodenal motility (manometric) study
  • 91065: Breath hydrogen or methane test (e.g., for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)
  • 91112: Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report
  • 91132: Electrogastrography, diagnostic, transcutaneous
  • 91133: Electrogastrography, diagnostic, transcutaneous; with provocative testing
  • 43263: Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi

In addition, the following ANMS-sponsored manuscript reviewed the topic of billing and coding for GI motility procedures.

 KHAN A, MASSEY B, RAO S, PANDOLFINO J. ESOPHAGEAL FUNCTION TESTING: BILLING AND CODING UPDATE. NEUROGASTROENTEROL MOTIL. 2018;30(1).

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.

(6/22/2018)