Gastroenterology Coding Alert

Question: Our GI physician performed a liver elastography using mechanical shear wave technique to investigate whether tumors in the liver were nonmalignant. Can we report 91299 for this procedure?

Florida Subscriber

Answer: CPT^® code 91299 (Unlisted diagnostic gastroenterology procedure) is an unlisted code, which should be used if a more specific code does not exist — however, in your case, one does.

You should report 91200 (Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report) for testing the elastic properties of the liver without imaging, which would be more appropriate here. This code describes liver fibrosis evaluation, includes interpretation and report, but not imaging. However, elastography is used to assess the degree of fatty change or of liver fibrosis, not to assess nature of a liver mass. For the latter, some form of liver ultrasonography (an imaging study), a CT scan, or MRI scan would ordinarily be used.