How To Use CPT Code 91113

CPT 91113 describes the imaging of the gastrointestinal tract, specifically the colon, using an intraluminal method such as capsule endoscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 91113?

CPT 91113 can be used to describe the imaging of the gastrointestinal tract, specifically the colon, using an intraluminal method. This code is used when a provider utilizes a capsule fitted with a camera that the patient swallows to capture images of the colon as it passes through the digestive tract. The provider then interprets these images and prepares a report of the findings.

2. Official Description

The official description of CPT code 91113 is: ‘Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report. (Do not report 91113 in conjunction with 91110, 91111). (Incidental visualization of the esophagus, stomach, duodenum, and/or ileum is not reported separately)’

3. Procedure

1. The patient swallows a disposable imaging capsule that contains a camera.
2. The capsule passes through the gastrointestinal tract, capturing color images of the colon.
3. The provider places image recording sensors on the patient’s abdomen to receive the images sent by an antenna on the capsule.
4. The provider transfers the data to a computer for analysis and interpretation.
5. A report of the findings is prepared based on the analysis of the captured images.

4. Qualifying circumstances

CPT 91113 is used when a provider performs intraluminal imaging of the colon using a capsule endoscopy method. This procedure is typically done to detect and diagnose abnormalities in the gastrointestinal tract. It should not be reported in conjunction with CPT codes 91110 or 91111. Incidental visualization of the esophagus, stomach, duodenum, and/or ileum is not reported separately.

5. When to use CPT code 91113

CPT code 91113 should be used when a provider performs intraluminal imaging of the colon using a capsule endoscopy method. It is appropriate when the focus of the study is on the colon and when the provider interprets and reports the findings. This code should not be used in conjunction with CPT codes 91110 or 91111, which represent other gastrointestinal imaging procedures.

6. Documentation requirements

To support a claim for CPT 91113, the provider must document the following information:

• Reason for the procedure and the need for intraluminal imaging of the colon
• Details of the imaging capsule used
• Date of the procedure
• Start and end time of the procedure
• Analysis and interpretation of the captured images
• Report of the findings

7. Billing guidelines

When billing for CPT 91113, ensure that the provider performs intraluminal imaging of the colon using a capsule endoscopy method. Do not report this code in conjunction with CPT codes 91110 or 91111. Incidental visualization of other parts of the gastrointestinal tract should not be reported separately. Follow the specific guidelines provided by the payer for accurate and appropriate billing.

8. Historical information

CPT 91113 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes intraluminal imaging of the colon using a capsule endoscopy method to detect any abnormalities.
2. A provider performs intraluminal imaging of the colon using a capsule endoscopy method and prepares a report of the findings.
3. Intraluminal imaging of the colon using a capsule endoscopy method is performed on a patient with suspected gastrointestinal issues.
4. A provider interprets the images captured during intraluminal imaging of the colon using a capsule endoscopy method and reports the findings.
5. A patient undergoes intraluminal imaging of the colon using a capsule endoscopy method to evaluate their gastrointestinal health.
6. A provider utilizes a capsule fitted with a camera to capture images of the colon as it passes through the gastrointestinal tract for diagnostic purposes.
7. Intraluminal imaging of the colon using a capsule endoscopy method is performed to investigate potential abnormalities in the gastrointestinal tract.
8. A provider analyzes and interprets the images obtained through intraluminal imaging of the colon using a capsule endoscopy method.
9. A patient undergoes intraluminal imaging of the colon using a capsule endoscopy method to aid in the diagnosis of gastrointestinal conditions.
10. A provider performs intraluminal imaging of the colon using a capsule endoscopy method and prepares a comprehensive report based on the captured images.