CPT code 91117 is a medical billing code for a 6-hour colon motility study used to assess bowel function.
CPT code 91117 is used to describe a colon motility study that lasts for six hours. This procedure assesses how well the muscles in the colon are functioning by measuring the movement of a marker through the digestive tract over the specified time period. It helps healthcare providers evaluate conditions related to bowel function and motility disorders.
When billing for CPT code 91117 (Colon motility 6 hr study), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the test results, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the equipment, supplies, and technical staff involved in the procedure.
3. Modifier 52 - Reduced Services: This modifier is used when the service provided is less extensive than what is typically required. It indicates that the procedure was partially reduced or eliminated at the discretion of the provider.
4. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to identify procedures that are not normally reported together but are appropriate under the circumstances.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when a procedure or service is repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure or service is repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
8. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when the same laboratory test is performed more than once on the same day for the same patient.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement. Always verify payer-specific guidelines as they may have unique requirements or restrictions regarding the use of these modifiers.
CPT code 91117 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS) and is eligible for payment. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. Healthcare providers should consult their local MAC for specific coverage guidelines and documentation requirements related to CPT 91117.
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