Wednesday, April 20, 2016

CPT CODE 78264, 78265, A9541 and covered ICD 10 code

Gastric Emptying Scintigraphy—CPT and ICD-9/ICD-10 Covered Indications

Claims submitted with non-covered indication will be denied as provider liable.


CPT Description

78264 Gastric emptying study (gastric emptying scintigraphy)
78265 Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit
78266 Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days

Related coding—Radiopharmaceutical diagnostic imaging agents that deny when gastric emptying scintigraphy is denied for a non covered indication:

A9541 Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to20 mci’s
A4641 Radiopharmaceutical, diagnostic, not otherwise classified


ICD‐10 CM ‐  Diagnosis Code ICD‐10 CM ‐ Diagnosis Description

K21.9 Gastro‐esophageal reflux disease without esophagitis
K22.0 Achalasia of cardia
K30 Functional dyspepsia
K50.012 Crohn's disease of small intestine with intestinal obstruction
K50.112 Crohn's disease of large intestine with intestinal obstruction
K50.812 Crohn's disease of both small and large intestine with intestinal obstruction
K50.912 Crohn's disease, unspecified, with intestinal obstruction
K51.012 Ulcerative (chronic) pancolitis with intestinal obstruction
K51.212 Ulcerative (chronic) proctitis with intestinal obstruction
K51.312 Ulcerative (chronic) rectosigmoiditis with intestinal obstruction
K51.512 Left sided colitis with intestinal obstruction
K51.812 Other ulcerative colitis with intestinal obstruction
K51.912 Ulcerative colitis, unspecified with intestinal obstruction
K56.0 Paralytic ileus
K56.1 Intussusception
K56.2 Volvulus
K56.3 Gallstone ileus
K56.41 Fecal impaction
K56.49 Other impaction of intestine
K56.5 Intestinal adhesions [bands] with obstruction (postprocedural) (postinfection)
K56.60 Unspecified intestinal obstruction
K56.69 Other intestinal obstruction
K56.7 Ileus, unspecified
K59.8 Other specified functional intestinal disorders
R11.0 Nausea
R11.10 Vomiting, unspecified
R11.11 Vomiting without nausea
R11.12 Projectile vomiting
R11.14 Bilious vomiting
R11.2 Nausea with vomiting, unspecified
R12 Heartburn
R13.0 Aphagia
R13.10 Dysphagia, unspecified
R13.11 Dysphagia, oral phase
R13.12 Dysphagia, oropharyngeal phase
R13.13 Dysphagia, pharyngeal phase
R13.14 Dysphagia, pharyngoesophageal phase
R13.19 Other dysphagia
R14.0 Abdominal distension (gaseous)
R14.1 Gas pain
R14.2 Eructation
R14.3 Flatulence
R15.0 Incomplete defecation
R15.1 Fecal smearing
R15.2 Fecal urgency
R15.9 Full incontinence of feces
R19.11 Absent bowel sounds
R19.12 Hyperactive bowel sounds
R19.15 Other abnormal bowel sounds
R19.2 Visible peristalsis
R19.4 Change in bowel habit
R19.5 Other fecal abnormalities
R19.7 Diarrhea, unspecified

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