Gastroenterology Coding Alert

Question: Our new gastroenterologist just started using Sitzmark tests.  How shall I bill for that and do we need to be CLIA compliant for this?

Maryland Subscriber

Answer: The Sitzmark test is a test to check for colon transit time. This helps your gastroenterologist assess the patient for motility disorders and functional outlet obstructions. The test will involve the patient ingesting radioopaque marker(s) and then your gastroenterologist will take abdominal x-ray(s) to check the progress of the markers and thus assess the colon transit time.

In order to bill for a Sitzmark test, you need not have to worry about being CLIA compliant as this test is not a lab test.

You will need to report the supply of the radioopaque markers using the supply CPT^® code 99070 (Supplies and materials [except spectacles], provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]). But as 99070 is a general code for all supplies, you will need to specify in the documentation what the code is being used for. You will need to report one unit of 99070 for every capsule that your gastroenterologist provides to the patient to ingest.

You will need to report 74000 (Radiologic examination, abdomen; single anteroposterior view) for every x-ray film that your gastroenterologist orders and interprets. This of course assumes that your practice owns the radiology equipment.  If your physician only orders the x-rays and receives a report then the radiologist will bill 74000 for the radiologic service.  The date of service should be the date on which these x-rays were performed and not on the day the x-rays were interpreted.