Pathology/Lab Coding Alert

Question: We usually bill pH as 82803, for a blood specimen, but we got an order for an esophageal acid reflux test that involves a nasal catheter to test pH in the esophagus. Should we use 82930?

Kentucky Subscriber

Answer: No, you should not report 82930 (Gastric acid analysis, includes pH if performed, each specimen) in this case.

What you’ve described is not an in vitro lab test, but instead is an in vivo procedure performed by a physician. The correct code for esophageal acid reflux testing that involves inserting a nasal catheter and placing pH electrodes into the esophagus is 91034 (Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation).

Other codes: CPT^® provides several other codes for pH, depending on the specimen and possibly test method. To help you select the correct code, you should also be familiar with the following:

• 82800 (Gases, blood, pH only)
• 82803 (Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation)) Use this code if the lab tests any two or more of the listed analytes.
• 83986 (pH; body fluid, not otherwise specified)
• 83987 (pH; exhaled breath condensate)
• 81000-81003 (Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; …)