CPT code 91037 is a medical billing code for the esophageal impedance function test, used to assess esophageal conditions.
CPT code 91037 is used to describe an esophageal impedance function test. This test measures the movement of substances through the esophagus and assesses how well the esophagus is functioning, particularly in relation to swallowing and reflux. It helps healthcare providers evaluate conditions such as gastroesophageal reflux disease (GERD) by monitoring the presence of acid and non-acid reflux in the esophagus.
Modifiers for CPT Code 91037 - Esophageal Impedance Function Test:
1. Modifier 22 - Increased Procedural Services
- Use this modifier when the work required to perform the procedure is substantially greater than typically required.
2. Modifier 26 - Professional Component
- This modifier is used when only the professional component of the service is being billed, such as the interpretation of the test results.
3. Modifier 52 - Reduced Services
- Apply this modifier when the procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure
- Use this modifier if the procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
- This modifier is used when the same procedure is repeated by the same provider.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional
- Use this modifier when the same procedure is repeated by a different provider.
7. Modifier 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
- This modifier is used when the patient returns to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Apply this modifier when an unrelated procedure is performed by the same provider during the postoperative period.
9. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test
- This modifier is used when the same laboratory test is performed on the same day to obtain subsequent test results.
10. Modifier 99 - Multiple Modifiers
- Use this modifier when two or more modifiers are necessary to describe the service provided.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the esophageal impedance function test.
The CPT code 91037, which is used for a specific medical procedure, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B.
Additionally, it is important to consult with the Medicare Administrative Contractor (MAC) for your specific region, as they are responsible for processing Medicare claims and can provide detailed information on coverage and reimbursement policies for CPT code 91037.
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