Summary & Overview
CPT 91037: Gastroesophageal Reflux Monitoring with Transnasal Impedance
CPT code 91037 represents ambulatory gastroesophageal reflux monitoring using a transnasal catheter with intraluminal impedance electrode placement; the provider records and interprets the test report. This diagnostic procedure is used to detect and characterize acid and non-acid reflux events, informing management of reflux-related symptoms and guiding therapeutic decisions. Nationally, accurate coding and consistent use of 91037 matter for clinical documentation, quality measurement, and claims processing for outpatient gastroenterology services.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical sites of service, a summary of payer coverage considerations, and benchmarking context where available. The publication highlights coding specifics for the procedure, common modifiers listed in payer policies, and operational considerations for ambulatory monitoring programs. It also situates 91037 within broader diagnostic workflows for gastroesophageal reflux disease and related symptom evaluation.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 91037 describes a gastroesophageal reflux test that assesses the backflow of stomach acid into the esophagus using a nasal catheter with intraluminal impedance electrode placement. The provider places the nasal catheter, records the monitoring session, and interprets the resulting report.
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Service type: Ambulatory physiologic reflux monitoring with transnasal intraluminal impedance
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Typical site of service: Ambulatory clinic or outpatient diagnostic laboratory (transnasal catheter placement and ambulatory monitoring)
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to a gastroenterology clinic with chronic heartburn, regurgitation, and atypical chest pain despite proton pump inhibitor therapy. The gastroenterologist recommends ambulatory esophageal reflux testing using a combined intraluminal impedance and pH catheter placed transnasally to quantify acid and non-acid reflux events and correlate symptoms. The procedure is performed in the outpatient endoscopy suite: topical nasal anesthesia is applied, a combined impedance-pH catheter is advanced transnasally and positioned with the impedance electrodes and pH sensor across the distal esophagus, correct positioning is confirmed, and the catheter is secured. The provider collects ambulatory recording data for the prescribed monitoring period, retrieves the device/report, reviews impedance/pH tracings, and documents interpretation and a formal report. Typical site of service is an outpatient ambulatory surgery center or gastroenterology clinic with monitoring equipment; the service type is diagnostic ambulatory esophageal impedance-pH monitoring. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient visit, established patient | Use when the professional performs the service in an outpatient clinic and this is the primary service for the visit. |