Time is a crucial element while selecting between 91037 and 91038.
When your physician's note proposes impedance and pH tests being carried out together, you would turn to the 9103x series of your medical CPT manual. Easy? Not exactly. Take the following scenario in point.
Scenario: The motility specialist carries out impedance + pH test for over an hour. The patient, who complains of recurrent as well as painful heartburn, leaves the office with the catheter in position till the next day.
Dilemma: Can you bill 91038 by itself, or do you require to add 91034 at all?
The key is to recognize what each code involves, but you should not just base your choice on the obvious. You must give weight to Correct Coding Initiative (CCI) edits, too. These guidelines should keep you on the right track.
1. Look for 91037-91038 for Impedance Catheter
While reporting esophageal function (impedance) tests, you would define it using two medical CPT codes:
When your physician's note proposes impedance and pH tests being carried out together, you would turn to the 9103x series of your medical CPT manual. Easy? Not exactly. Take the following scenario in point.
Scenario: The motility specialist carries out impedance + pH test for over an hour. The patient, who complains of recurrent as well as painful heartburn, leaves the office with the catheter in position till the next day.
Dilemma: Can you bill 91038 by itself, or do you require to add 91034 at all?
The key is to recognize what each code involves, but you should not just base your choice on the obvious. You must give weight to Correct Coding Initiative (CCI) edits, too. These guidelines should keep you on the right track.
1. Look for 91037-91038 for Impedance Catheter
While reporting esophageal function (impedance) tests, you would define it using two medical CPT codes:
Keep in mind the descriptors for 91037 and 91038 represent a time measurement, which implies that you must apply 91037 for testing that goes up to one hour. In case the monitoring goes for more than one hour, bill 91038 as a substitute. You should not bill both codes for the same test. You should apply only a single code to report the session.
What happens: In an impedance test, the catheter goes in the patient's body transnasally. This particular test measures bolus transit dynamics along with either pH measurement or esophageal muscular function in the assessment of symptoms involving chest pain, swallowing trouble, or chronic heartburn which is unresponsive to medication. At times, physicians would carry out these tests in conjunction with manometry or pH testing.
Together motility study (manometry) as well as esophageal function testing uses a nasal catheter. Though, the impedance probe is multi-purpose and measures more much more than the motility test (91010, Esophageal motility [manometric study of the esophagus and/or gastroesophageal junction] study with interpretation and report; 2-dimensional data) or the gastroesophageal reflux test (91034, Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode[s] placement, recording, analysis and interpretation).
2. Single Code Defines Cather-Based pH Test
When a gastroenterologist carries out an esophageal acid reflux test using either a disposable or a reusable nasal catheter, you would then reportmedical CPT 91034.
Pointer: Medical CPT 91034 should be your go-to code irrespective of how long the nasal catheter remains in place. Generally, though, the physician will leave the catheter in place for about a day. Earlier, you had to differentiate between standard and "extended" pH monitoring. Currently, only single code (91034) defines a catheter-based pH service.
What happens: In an impedance test, the catheter goes in the patient's body transnasally. This particular test measures bolus transit dynamics along with either pH measurement or esophageal muscular function in the assessment of symptoms involving chest pain, swallowing trouble, or chronic heartburn which is unresponsive to medication. At times, physicians would carry out these tests in conjunction with manometry or pH testing.
Together motility study (manometry) as well as esophageal function testing uses a nasal catheter. Though, the impedance probe is multi-purpose and measures more much more than the motility test (91010, Esophageal motility [manometric study of the esophagus and/or gastroesophageal junction] study with interpretation and report; 2-dimensional data) or the gastroesophageal reflux test (91034, Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode[s] placement, recording, analysis and interpretation).
2. Single Code Defines Cather-Based pH Test
When a gastroenterologist carries out an esophageal acid reflux test using either a disposable or a reusable nasal catheter, you would then reportmedical CPT 91034.
Pointer: Medical CPT 91034 should be your go-to code irrespective of how long the nasal catheter remains in place. Generally, though, the physician will leave the catheter in place for about a day. Earlier, you had to differentiate between standard and "extended" pH monitoring. Currently, only single code (91034) defines a catheter-based pH service.
