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Official Description

Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Esophageal function testing, specifically gastroesophageal reflux impedance testing, is a diagnostic procedure designed to assess the functionality of the esophagus in relation to gastroesophageal reflux disease (GERD). This test evaluates esophageal peristalsis, which is the wave-like muscle contractions that move food down the esophagus, and monitors both acidic and non-acidic reflux over an extended duration. The procedure involves the placement of a nasal catheter equipped with intraluminal impedance electrodes, which are specialized sensors that detect changes in electrical resistance within the esophagus. These electrodes are strategically positioned to capture data on the movement of a saline solution and a viscous material as they pass through the esophagus. By analyzing the recordings from these electrodes, healthcare professionals can gain insights into the dynamics of esophageal function, including how effectively the esophagus transports the bolus into the stomach. This comprehensive evaluation is crucial for diagnosing conditions related to esophageal motility and reflux, ultimately guiding appropriate treatment options for patients experiencing symptoms of GERD.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Gastroesophageal reflux impedance testing is indicated for the evaluation of various symptoms and conditions related to esophageal function and reflux. The following are the explicitly provided indications for this procedure:

  • Assessment of GERD: This test is performed to evaluate patients suspected of having gastroesophageal reflux disease, particularly when traditional pH monitoring may not provide sufficient information.
  • Evaluation of Esophageal Motility Disorders: It is used to assess the motility of the esophagus, helping to identify any abnormalities in peristalsis that may contribute to reflux symptoms.
  • Investigation of Atypical Symptoms: The procedure is indicated for patients presenting with atypical symptoms of reflux, such as chronic cough, laryngitis, or asthma, which may not be explained by standard reflux assessments.
  • Preoperative Assessment: It may be utilized in the preoperative evaluation of patients undergoing surgical interventions for reflux disease to ensure appropriate surgical planning.

2. Procedure

The gastroesophageal reflux impedance test involves several key procedural steps that are critical for accurate assessment of esophageal function. The following outlines the detailed steps of the procedure:

  • Step 1: Catheter Placement - A nasal catheter containing intraluminal impedance electrodes is inserted into the patient's nose and carefully advanced into the esophagus. The distal impedance electrode is positioned approximately 5 cm above the distal esophageal sphincter to ensure optimal measurement of reflux events.
  • Step 2: Saline Swallowing Protocol - Once the catheter is in place, the patient is administered a saline solution. The patient is instructed to take 10 swallows of the saline at intervals of 20 to 30 seconds. During this phase, the electrodes measure and record the bolus transit times and assess the dynamics of esophageal function as the saline bolus moves through the esophagus.
  • Step 3: Viscous Material Swallowing Protocol - Following the saline swallowing, the patient is given a viscous material to swallow, again taking 10 swallows at 20 to 30 second intervals. The electrodes continue to measure and record bolus transit times and esophageal function during this phase, providing additional data on how the esophagus handles different consistencies of material.
  • Step 4: Catheter Removal - After the completion of the swallowing protocols, the catheter is carefully removed from the patient's nose. This step concludes the data collection phase of the procedure.
  • Step 5: Data Analysis and Reporting - The physician evaluates the recordings captured by the electrodes, analyzing the data to assess esophageal function. A comprehensive written report is then generated, summarizing the findings and providing insights into the patient's esophageal health.

3. Post-Procedure

After the gastroesophageal reflux impedance test is completed, the patient may experience some mild discomfort due to the catheter placement, but this typically resolves quickly. There are no specific post-procedure care requirements mentioned; however, patients are generally advised to resume normal activities unless otherwise directed by their healthcare provider. The physician will review the results of the test and discuss any necessary follow-up actions or treatment options based on the findings. It is important for patients to understand the significance of the results and how they may impact their ongoing management of esophageal conditions.

Short Descr ESOPH IMPED FUNCTION TEST
Medium Descr GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD
Long Descr Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance 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
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.
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).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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
GA Waiver of liability statement issued as required by payer policy, individual case
RT Right side (used to identify procedures performed on the right side of the body)
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2010-01-01 Changed Code description changed.
2005-01-01 Added First appearance in code book in 2005.
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