Gastroenterology Coding Alert

Question: We tried to do a 24-hour pH monitoring of a patient's esophageal acid reflux, but could monitor him for only 14 hours. What code do we use to report this service?

Idaho Subscriber

Answer: To report esophageal acid reflux tests, you have only one code? (91034, Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode[s] placement, recording, analysis, and interpretation). Full 24-hour monitoring is the most common procedure, but you can still use 91034 to report monitoring sessions of less than 24 hours. Notice how 91034's descriptor does not specify time.

What happens: With esophageal acid reflux pH monitoring, the physician inserts a probe into the patient's nose. The probe passes through to the esophagus. The physician attaches the probe to a cassette that records the extent of the patient's acid reflux for several hours. After the physician activates the cassette, the patient goes home and records acid reflux symptoms in a diary. When the patient returns, the physician removes the probe. The GI downloads the data on the cassette and puts it in graphic form. Then he looks at the graph of the data and the patient's diary for interpretation.

The standard in esophageal acid reflux tests is 24-hour monitoring. You can have shorter periods, but that is rare. Some patients may not be able to tolerate 24-hours with a probe inserted in their nose.