© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 91113 involves gastrointestinal tract imaging using an intraluminal device, specifically a capsule endoscopy. This innovative technique utilizes a small, disposable capsule that contains a miniature endoscope equipped with a camera. The complete system also includes sensing and transmission devices, along with a data recorder that the patient wears. The primary purpose of this procedure is to obtain detailed images of the colon, particularly in cases where traditional colonoscopy has proven to be technically impossible, or when there has been incomplete fecal evacuation or issues with bowel preparation. During the procedure, the patient swallows the capsule, which then travels through the gastrointestinal tract propelled by natural peristaltic movements. As the capsule moves, it captures images of the colon at two-second intervals. These images are wirelessly transmitted to a recorder worn around the patient's waist. After the imaging process is complete, which typically occurs within approximately 24 hours, the collected data is downloaded to a workstation computer for thorough interpretation. A comprehensive report detailing the findings is then generated, providing valuable insights into the condition of the colon, including the detection of polyps and tumors.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure is indicated for the following conditions:
The procedure involves several key steps to ensure effective imaging of the colon:
After the capsule endoscopy, the patient can typically resume normal activities immediately. The capsule is expected to be expelled naturally within about 24 hours. Patients may be advised to monitor for any unusual symptoms following the procedure. The healthcare provider will review the interpreted data and findings from the capsule endoscopy, providing a comprehensive report that may guide further diagnostic or therapeutic actions based on the results.
| Short Descr | GI TRC IMG INTRAL COLON I&R |
| Medium Descr | GI TRACT IMAGING INTRALUMINAL COLON I&R |
| Long Descr | Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, 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 |
| Berenson-Eggers TOS (BETOS) | none |
| MUE | 1 |
| 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). |
| GC | This service has been performed in part by a resident under the direction of a teaching physician |
| GZ | Item or service expected to be denied as not reasonable and necessary |
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Date
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Action
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Notes
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|---|---|---|
| 2022-01-01 | Added | Code added |
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Code
|
Description
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|---|---|
| B17.0 | Acute delta-(super) infection of hepatitis B carrier |
| B17.10 | Acute hepatitis C without hepatic coma |
| B17.11 | Acute hepatitis C with hepatic coma |
| B17.8 | Other specified acute viral hepatitis |
| B17.9 | Acute viral hepatitis, unspecified |
| B18.0 | Chronic viral hepatitis B with delta-agent |
| B18.1 | Chronic viral hepatitis B without delta-agent |
| B18.2 | Chronic viral hepatitis C |
| B18.8 | Other chronic viral hepatitis |
| B18.9 | Chronic viral hepatitis, unspecified |
| B19.10 | Unspecified viral hepatitis B without hepatic coma |
| B19.20 | Unspecified viral hepatitis C without hepatic coma |
| B19.9 | Unspecified viral hepatitis without hepatic coma |
| E83.110 | Hereditary hemochromatosis |
| K63.5 | Polyp of colon |
| K70.0 | Alcoholic fatty liver |
| K70.10 | Alcoholic hepatitis without ascites |
| K70.11 | Alcoholic hepatitis with ascites |
| K70.2 | Alcoholic fibrosis and sclerosis of liver |
| K70.30 | Alcoholic cirrhosis of liver without ascites |
| K70.31 | Alcoholic cirrhosis of liver with ascites |
| K70.40 | Alcoholic hepatic failure without coma |
| K70.9 | Alcoholic liver disease, unspecified |
| K71.7 | Toxic liver disease with fibrosis and cirrhosis of liver |
| K73.0 | Chronic persistent hepatitis, not elsewhere classified |
| K73.1 | Chronic lobular hepatitis, not elsewhere classified |
| K73.2 | Chronic active hepatitis, not elsewhere classified |
| K73.8 | Other chronic hepatitis, not elsewhere classified |
| K73.9 | Chronic hepatitis, unspecified |
| K74.0 | Hepatic fibrosis [] |
| K74.2 | Hepatic fibrosis with hepatic sclerosis |
| K74.60 | Unspecified cirrhosis of liver |
| K74.69 | Other cirrhosis of liver |
| K75.4 | Autoimmune hepatitis |
| K75.9 | Inflammatory liver disease, unspecified |
| K76.89 | Other specified diseases of liver |
| K76.9 | Liver disease, unspecified |
| K92.1 | Melena |
| K92.2 | Gastrointestinal hemorrhage, unspecified |
| R19.5 | Other fecal abnormalities |
| R74.0 | Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH] [deleted] |
| R74.8 | Abnormal levels of other serum enzymes |
| R74.9 | Abnormal serum enzyme level, unspecified |
| R76.8 | Other specified abnormal immunological findings in serum |
| R76.9 | Abnormal immunological finding in serum, unspecified |
| R79.0 | Abnormal level of blood mineral |
| R79.89 | Other specified abnormal findings of blood chemistry |
| R79.9 | Abnormal finding of blood chemistry, unspecified |
| R93.2 | Abnormal findings on diagnostic imaging of liver and biliary tract |
| R94.5 | Abnormal results of liver function studies |
| Z48.23 | Encounter for aftercare following liver transplant |
| Z53.09 | Procedure and treatment not carried out because of other contraindication |
| Z53.8 | Procedure and treatment not carried out for other reasons |
| Z94.4 | Liver transplant status |
| No matching codes found | |