CPT code 91133 is for electrogastrography with testing, a procedure that measures electrical activity in the stomach.
CPT code 91133 is for electrogastrography with testing. This procedure involves measuring the electrical activity of the stomach to assess its function. It typically includes the placement of electrodes on the skin to record the stomach's electrical signals, helping healthcare providers diagnose conditions related to gastric motility and function.
For CPT code 91133 (Electrogastrography w/test), the following modifiers may be applicable:
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 use of equipment and supplies, as well as the technician's time, but not the interpretation of the results.
3. 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 prevent bundling and ensure separate reimbursement for the electrogastrography when performed in conjunction with other procedures.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same physician repeats the procedure on the same day. It indicates that the repeat procedure was necessary and not a duplicate billing.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a different physician repeats the procedure on the same day. It indicates that the repeat procedure was necessary and not a duplicate billing.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: This modifier is used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results. It indicates that the repeat test was necessary for clinical reasons.
7. Modifier 99 - Multiple Modifiers: This modifier is used when two or more modifiers are necessary to describe the service provided. It indicates that multiple modifiers are being applied to the CPT code.
These modifiers help ensure accurate billing and reimbursement for the specific components and circumstances of the electrogastrography procedure.
The CPT code 91133, which pertains to electrogastrography with a test, is subject to reimbursement by Medicare, but it is essential to verify its status on the Medicare Physician Fee Schedule (MPFS).
The MPFS provides detailed information on whether a specific CPT code is covered and the reimbursement rates. Additionally, coverage and reimbursement can vary based on the policies of the Medicare Administrative Contractor (MAC) for your region.
Therefore, it is advisable to consult the MPFS and your local MAC to confirm the reimbursement status and any specific requirements or limitations associated with CPT code 91133.
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