Gastroenterology Coding Alert

Question: A fifty year old male patient, complaining of heart burn, is diagnosed as having gastro-esophageal reflux disease with esophagitis. The provider performs gastroesophageal reflux test on this patient to determine the backflow of acid from the stomach into the esophagus with telemetry pH electrode placement. Which code shall we report?

Utah Subscriber

Answer: You may report 91035 (Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation), as well as the ICD-10-CM code K21.0 (Gastro-esophageal reflux disease with esophagitis). If you are reporting only the professional component for the service, you should append modifier 26, (Professional component) to the code.

You may think of 91034 (Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode[s] placement, recording, analysis and interpretation), when the provider performs gastroesophageal reflux test with pH electrode placement, devoid of telemetry component.

Consider reporting 91037 (Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode[s] placement, recording, analysis and interpretation) when the provider performs gastroesophageal reflux test using the nasal catheter intraluminal impedance electrode placement.

In case your provider performed the gastroesophageal reflux test for more than one hour; up to 24 hours- to determine the back flow of acid from the stomach into the esophagus using nasal catheter intraluminal impedance electrode placement, you may report 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).