Summary & Overview
CPT 92613: Endoscopic Swallowing Study Interpretation and Report
CPT code 92613 represents the professional interpretation and reporting of a video-recorded endoscopic swallowing study, used to evaluate causes of dysphagia. Nationally, this code supports documentation of diagnostic conclusions that guide clinicians in managing swallowing disorders, impacting reimbursement for specialty services in otolaryngology, gastroenterology, speech-language pathology collaborations, and hospital-based clinics. Coverage and billing practices for this code influence access to diagnostic evaluation for patients with complex swallowing impairments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage considerations, typical sites of service, common modifiers and coding context, and how CPT code 92613 fits into the clinical workflow for endoscopic swallowing assessment. The report outlines benchmarks and policy-relevant details such as documentation expectations and reporting elements needed to support payment. Clinical context summarizes when the test is used and who typically performs and interprets the study.
Data not available in the input is noted where applicable. This summary is written for a national audience interested in coding, billing, and clinical use of CPT code 92613 for endoscopic swallowing study interpretation and reporting.
Billing Code Overview
CPT code 92613 describes a provider's interpretation of a video-recorded endoscopic swallowing study with preparation of a written report of findings. This service involves clinical analysis of recorded endoscopic footage to determine the cause of a patient’s swallowing difficulties and to document relevant diagnostic impressions.
-
Service type: Diagnostic interpretation and reporting
-
Typical site of service: Hospital outpatient department, specialized swallowing clinic, otolaryngology or gastroenterology clinic, or other facilities where endoscopic swallowing studies are performed
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with recent stroke is referred to otolaryngology and speech-language pathology for evaluation of persistent dysphagia and aspiration risk. The patient has intermittent coughing with oral intake, unexplained weight loss, and a history of recurrent pneumonias. An endoscopic swallowing study (fiberoptic endoscopic evaluation of swallowing, FEES) is performed by an otolaryngologist or trained speech-language pathologist during which a flexible endoscope is passed transnasally to visualize the laryngeal and pharyngeal structures while the patient swallows food and liquids of varying consistencies. The examination is video recorded.
The interpreting provider (often an otolaryngologist or a physician with swallowing expertise) reviews the video recording after the procedure to determine the physiologic cause(s) of the patient’s swallowing difficulties (for example, impaired laryngeal elevation, delayed swallow initiation, reduced pharyngeal constriction, or penetration/aspiration). The provider generates a formal written report documenting findings, interpretation, recommended diet modifications, and potential need for further interventions (e.g., swallow therapy, instrumental fluoroscopic study, or surgical referral). The service is commonly billed when the interpretation and report are completed separate from or subsequent to the bedside/performing clinician’s documentation of the endoscopic exam.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |