CPT code 91030 is a medical billing code for the procedure involving acid perfusion of the esophagus, used to diagnose esophageal conditions.
CPT code 91030 is used to describe the procedure of acid perfusion of the esophagus. This diagnostic test involves the introduction of a saline solution with a controlled acid concentration into the esophagus to evaluate its sensitivity to acid and to help diagnose conditions such as gastroesophageal reflux disease (GERD). The procedure is typically performed to assess the esophageal lining's response to acid exposure, aiding healthcare providers in determining the appropriate treatment for patients experiencing esophageal discomfort or related symptoms.
For CPT code 91030, which pertains to the acid perfusion of the esophagus, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 26 - Professional Component
- Indicates that the service provided was the professional component only, such as the interpretation of results.
3. Modifier 52 - Reduced Services
- Applied when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure
- Used when a procedure is terminated due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Indicates that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Used when the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician
- Indicates that the same procedure is repeated by a different physician.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- Used when a related procedure is performed during the postoperative period of the initial procedure.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that an unrelated procedure or service was performed by the same physician during the postoperative period.
10. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test
- Used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results.
11. Modifier 99 - Multiple Modifiers
- Indicates that multiple modifiers are applicable to the service provided.
These modifiers help to provide additional information about the service performed and ensure accurate billing and reimbursement.
CPT code 91030 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's important to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.
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