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Gastrointestinal tract imaging, specifically through intraluminal methods such as capsule endoscopy, is a non-invasive diagnostic procedure that allows for detailed visualization of the esophagus. In this procedure, the patient ingests a small, pill-sized endoscopic capsule after fasting for a period of 10 hours. This capsule is equipped with a camera that captures color video images of the gastrointestinal (GI) tract as it travels through the esophagus and beyond. The patient is fitted with a data recorder worn around the waist, which receives and stores the images transmitted from the capsule. This setup enables the patient to continue their daily activities without interruption while the capsule collects valuable diagnostic information. After the capsule has passed through the GI tract, the recorded images are later reviewed and interpreted by a healthcare professional. The specific CPT® code 91111 is designated for imaging of the esophagus, while 91110 is used for imaging that extends from the esophagus through to the ileum.
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The procedure of gastrointestinal tract imaging via intraluminal capsule endoscopy is indicated for various clinical scenarios where visualization of the esophagus is necessary. The following conditions may warrant the use of this imaging technique:
The capsule endoscopy procedure involves several key steps to ensure accurate imaging of the esophagus:
After the completion of the capsule endoscopy, patients are typically advised to resume their normal activities and diet unless otherwise instructed by their healthcare provider. It is important to monitor for any unusual symptoms, such as abdominal pain or difficulty swallowing, which should be reported to a physician. The healthcare provider will review the interpreted images and report findings with the patient during a follow-up appointment, discussing any necessary further evaluations or treatments based on the results of the imaging.
| Short Descr | GI TRC IMG INTRAL ESOPHAGUS | Medium Descr | GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R | Long Descr | Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 98 - Other non-OR gastrointestinal therapeutic procedures |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | GC | This service has been performed in part by a resident under the direction of a teaching physician | GP | Services delivered under an outpatient physical therapy plan of care | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2024-01-01 | Note | Guideline information changed per Errata & Technical Corrections dated 08/02/2024. |
| 2022-01-01 | Changed | Short and Medium descriptions changed. Guidelines changed. |
| 2013-01-01 | Changed | Description changed. Guideline information changed. |
| 2011-01-01 | Changed | Guideline information changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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