Are you familiar with the latest gastroenterology CPT codes? If your work hasn’t allowed you to keep up with the changing code sets, this blog is the perfect opportunity to discover the most common CPT codes for gastroenterology procedures in 2024.
Long and unpredictable hours with intense work demands can be exhausting, especially in a stressful specialty like gastroenterology. In Medscape’s latest report on Gastroenterologist Lifestyle & Happiness, 55% of GI doctors expressed that they would accept less pay for an improved work-life balance.
This stat emphasizes the heavy workload of gastroenterologists. Incorrect coding can further add to their administrative burden. However, you can alleviate this load by understanding and applying the correct CPT codes for gastroenterology services.
- Understanding Gastroenterology
- Common Gastroenterology CPT Codes
- Gastroenterology CPT Codes for Diagnostic Procedures
- CPT Code 43200 – Esophagoscopy with Flexible Brush
- CPT Code 91010 – Esophagus Muscle Pressure & Movement Analysis
- CPT Code 91022 – Stomach Motility Analysis
- CPT Code 91034 – Gastroesophageal Reflux Test
- CPT Code 91035 – Gastroesophageal Reflux Test with Electrode
- CPT Code 91040 – Esophageal Balloon Dilation
- CPT Code 91065 – Breath Test
- CPT Code 91200 – Liver Elastography
- CPT Code 91133 – Electrogastrography
- Gastroenterology CPT Codes for Imaging Procedures
- Gastroenterology CPT Codes for Non-Surgical Procedures (Foreign Body Removal)
- Gastroenterology CPT Codes for Diagnostic Procedures
- Bottom Line
Understanding Gastroenterology
How often have you heard that a healthy gut is the key to your overall health? Gastroenterologists deal with persistent gut and digestive problems. So, gastroenterology is a medical specialty that manages the digestive system and its disorders. In simple words, it covers all organs in your digestive system, including:
The GI Tract
- Esophagus
- Stomach
- Intestines
Biliary Organs
- Liver
- Bile ducts
- Pancreas
- Gallbladder
Common Gastroenterology CPT Codes
The demand for gastroenterology continues to grow with the increasing number of gut problems. However, this growing popularity has made it difficult for GI practices to maintain coding and billing accuracy.
On top of that, the American Medical Association’s (AMA’s) annual coding updates create more confusion and chances of errors. So, if your primary tasks are keeping you from staying updated, you can scroll through our list to discover the most common gastroenterology CPT codes in 2024.
Gastroenterology CPT Codes for Diagnostic Procedures
CPT Code 43200 – Esophagoscopy with Flexible Brush
This gastroenterology CPT code addresses a diagnostic procedure of an esophagus. Billing specialists use it to indicate that a GI doctor has used a flexible endoscope to view a patient’s esophagus for pathologic analysis. In this procedure, the doctor passes the endoscope through the mouth to collect small tissue samples using a brush.
CPT Code 91010 – Esophagus Muscle Pressure & Movement Analysis
The 91010 CPT code refers to an upper gastrointestinal motility test. GI specialists use this code to inform payers that they have used a manometer to assess the muscle pressure and movement within a patient’s esophagus. This test is usually performed on people with gastroesophageal reflux disease (GERD).
CPT Code 91022 – Stomach Motility Analysis
This gastroenterology CPT code covers the motility analysis of a patient’s stomach. Billing specialists use the code 91022 to specify that a provider has performed a stomach and duodenal muscle pressure and movement test using a manometer. This analysis enables GI specialists to identify abnormalities in a patient’s stomach or small intestine muscles.
CPT Code 91034 – Gastroesophageal Reflux Test
The 91034 CPT code points towards a gastroesophageal reflux test. Billing experts use it to notify payers that a gastroenterologist has assessed acid reflux in a patient’s esophagus over 24 hours. During this diagnostic procedure, doctors insert a nasal catheter pH electrode, a thin tube with sensors, via a patient’s nose into their esophagus to detect acid and record the findings.
In short, this gastroenterology CPT code highlights an acid reflux test. However, you cannot bill this process separately. According to NCCI (National Correct Coding Initiative), effective since 2022, CPT code 91034 is bundled with 91038 when GI specialists perform both procedures simultaneously.
CPT Code 91035 – Gastroesophageal Reflux Test with Electrode
This CPT code is similar to 91034. However, it specifies pH monitoring via telemetry electrodes instead of a nasal catheter. The 91035 gastroenterology CPT code specifies that GI doctors have evaluated the severity of a patient’s gastroesophageal reflux disease by temporarily attaching a pH probe to their esophagus.
This device wirelessly transmits data to their computers and helps doctors manage these conditions.
CPT Code 91040 – Esophageal Balloon Dilation
The 91040 CPT code covers an esophageal balloon distension study. GI doctors use it after widening a narrowed section of a patient’s esophagus to determine the cause of their chest pain.
Gastroenterologists, during this procedure, use an endoscope to insert a deflated balloon into the lower esophageal sphincter. After that, they gradually fill the balloon to stretch the patient’s muscle fibers. The code also covers a chemical agent used by the doctor to prompt a response.
CPT Code 91065 – Breath Test
The 91065 CPT code refers to a hydrogen or methane breath test. As a billing specialist, you can use it to claim reimbursement for diagnosing problems related to gastric functionality, including bacterial overgrowth, lactose intolerance, and fructose deficiency.
GI specialists perform this test to analyze hydrogen and methane levels in a patient’s breath. While this test is non-invasive, it is only conducted after 8 to 12 hours of fasting.
CPT Code 91200 – Liver Elastography
91200 is one of the most commonly used CPT codes for gastroenterology. It refers to a liver elastography performed by doctors to determine the stiffness of the liver. This test helps GI specialists to assess conditions such as fibrosis and to distinguish between benign and malignant liver tumors.
CPT Code 91133 – Electrogastrography
This gastroenterology CPT code refers to a diagnostic transcutaneous electrogastrography. You can use the 91133 code to claim reimbursement for checking how well a patient’s stomach muscles are working.
During this procedure, GI doctors place electrodes over a patient’s abdomen to measure the electrical potential of a patient’s stomach muscles, including food movement. They use it to identify any motility disorders.
Gastroenterology CPT Codes for Imaging Procedures
CPT Code 91110 – Capsule Endoscopy
This CPT code falls within the range of gastrointestinal imaging, pressure measurement, and manometric studies. Billing specialists use the 91110 CPT code to bill a capsule endoscopy procedure for analyzing a patient’s digestive system.
During this process, the doctor tells a patient to swallow a tiny capsule containing a camera to take pictures of their gastrointestinal tract (esophagus to ileum). This non-invasive method is used to examine hard-to-reach areas with traditional endoscopy.
CPT Code 91122 – Anorectal Manometry
This gastroenterology CPT code also refers to an imaging process. GI doctors use the 91122 CPT code to notify payers that they have analyzed and measured a patient’s rectum and anal sphincter contraction. This test explores the reasons for constipation and other bowel movement issues in patients.
Gastroenterology CPT Codes for Non-Surgical Procedures (Foreign Body Removal)
CPT Code 43215 – Esophagoscopy with Removal of Foreign Body
This gastroenterology CPT code also highlights an esophagoscopy procedure. However, it is only used when GI doctors use a flexible esophagoscope to unblock the esophagus. During this procedure, gastroenterologists insert a flexible tube with a camera and light source on the other end inside a patient’s esophagus to identify and remove foreign bodies, usually large pieces of food.
CPT Code 43216 – Esophagoscopy with Removal of Tumor
The 43216 gastroenterology CPT code specifies a non-invasive esophagoscopy to remove abnormal growths. GI specialists use this gastroenterology CPT code to inform insurance companies that they have used a flexible tube with a camera and light source to look inside a patient’s esophagus and have removed one or more abnormal masses via biopsy forceps.
Following the procedure, the specialist sends the specimen to lab specialists for analysis.
Bottom Line
While gastroenterology conditions are easily manageable, their billing is a different story. GI doctors deal with a broad spectrum of digestive disorders with specific coding requirements.
If you are a GI specialist, use our list of common gastroenterology CPT codes to improve your coding accuracy. We have defined each code in detail so there is no confusion. But if you don’t want to take any risks, let a coding expert deal with your problems.
Many gastroenterology billing services offer standalone coding services so you can secure complete payments from payers on initial submission. Review the best options and choose the most cost-effective and reliable name for your practice.
