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Report codes 43235, 91035 for gastrointestinal endoscopy

APCs Weekly Monitor, April 27, 2005

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Report codes 43235, 91035 for gastrointestinal endoscopy

(Note: The APCs Weekly Monitor of March 22, 2005, included deleted CPT code 91033. Effective January 1, 2005, this code was replaced with CPT codes 91034 and 91035. The Monitor regrets the error.)

QUESTION: We have a physician that implants a PH monitoring capsule in the esophageal lumen via an upper gastrointestinal endoscopy. Can you please tell us what code or codes should be submitted when billing for these services?

ANSWER: Report 43235 for the upper gastrointestinal endoscopy.

You may also report CPT 91035 (Esophagus, gastroesophageal reflux test, with mucosal attached telemetry pH electrode(s) placement, recording, analysis and interpretation). This code involves placement of a capsule in the esophagus with the use of a detachable probe.

Here's how the procedure typically works: The capsule is left in place, and the patient leaves with a recording device which they wear for 48 hours. The capsule transmits data to the recording device during that time. The patient later returns to the endoscopy lab to return the recording device. The capsule is not removed, it dislodges itself and is passed by the patient.

Please note that CPT 91034 is used to report a traditional gastroesophageal reflux test with nasal catheter pH electrode(s) placement, recording, analysis and interpretation. The catheter remains in place for 24 to 48 hours and is removed later.

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