Gastroenterology Coding Alert

Question: One of our technicians administered a 24-hour acid reflux test (91034) for a patient in our office, but he could not complete the test. Our patient returned later that day complaining of extreme discomfort, so we removed the catheter. We were able to record only four hours. How should we code this? Is it a discontinued service?


Maine Subscriber


Answer: Although you did not complete the 24-hour test you originally intended, your case is not a discontinued service.  

If your gastroenterologist read and interpreted the four hours' worth of recording you did obtain, you should use 91034 (Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode[s] placement, recording, analysis and interpretation). Because your physician was able to complete part of this service, you can use this code.

Catch this: CPT deleted 91032 and 91033 a few years ago. You would have used them to distinguish between short-duration pH testing and prolonged pH testing. Now, for any nasal catheter pH testing, you'll use 91034. 

Don't forget: If this service had taken place in a hospital setting and your practice did not own the equipment used for the test, you would report 91034 with modifier 26 (Professional component).