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The CPT® Code 91034 refers to a specific diagnostic procedure known as the esophagus gastroesophageal reflux test, which is utilized to evaluate patients who exhibit symptoms indicative of gastroesophageal reflux disease (GERD). This test is particularly relevant for individuals who have been diagnosed with GERD but are not experiencing adequate relief from their current treatment regimen. The procedure involves the placement of a nasal catheter that contains a pH electrode, which is strategically positioned near the lower esophagus. This catheter is connected to a portable external monitor that the patient wears, typically secured around the waist or shoulder. Over a continuous monitoring period of 24 hours, the pH electrode measures the acidity levels within the esophagus. These pH levels fluctuate in response to the presence of stomach acid that may reflux into the esophagus, providing critical data regarding the frequency and duration of acid exposure. Patients are instructed to actively participate in the monitoring process by pressing a button on the external monitor to record specific events, such as the onset of symptoms, meal times, and changes in body position, which can all influence reflux episodes. After the monitoring period, the patient returns to the physician's office for the removal of the catheter, and the recorded data is subsequently analyzed and interpreted by the physician, culminating in a comprehensive written report that outlines the findings of the test.
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The esophagus gastroesophageal reflux test (CPT® Code 91034) is indicated for patients who present with symptoms suggestive of gastroesophageal reflux disease (GERD). This includes individuals who may experience:
The procedure for the esophagus gastroesophageal reflux test involves several key steps to ensure accurate measurement of esophageal pH levels:
Post-procedure care for the esophagus gastroesophageal reflux test primarily involves the removal of the catheter and the analysis of the recorded data. Patients may be advised to resume their normal activities immediately after the procedure, as there are typically no significant recovery concerns associated with the test. The physician will review the results and discuss the findings with the patient, which may include recommendations for further diagnostic testing or adjustments to the current treatment plan based on the test outcomes. It is important for patients to follow up with their healthcare provider to address any ongoing symptoms or concerns related to GERD.
| Short Descr | GASTROESOPHAGEAL REFLUX TEST | Medium Descr | GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT | Long Descr | Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 97 - Other gastrointestinal diagnostic procedures |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GZ | Item or service expected to be denied as not reasonable and necessary | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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