CPT® Code 91038

Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)

Gastroesophageal reflux impedance testing, identified by CPT® Code 91038, is a specialized diagnostic procedure designed to assess the function of the esophagus, particularly 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, specifically from greater than one hour up to 24 hours. The procedure involves the placement of a nasal catheter equipped with intraluminal impedance electrodes, which are sensors that detect changes in electrical resistance as the bolus of fluid passes through the esophagus. The distal impedance electrode is strategically positioned approximately 5 cm above the distal esophageal sphincter to accurately capture the dynamics of esophageal function. During the test, the patient ingests a saline solution followed by a viscous material, allowing for comprehensive analysis of bolus transit times and the esophagus's effectiveness in moving contents into the stomach. The data collected by the electrodes is crucial for the physician's evaluation of esophageal function, leading to a detailed written report that aids in diagnosis and treatment planning. For tests lasting less than one hour, CPT® Code 91037 should be utilized.