cpt code for gastric emptying study

Gastric Emptying Study: A Comprehensive Guide to the CPT Code and Its Applications

Introduction

A gastric emptying study (GES) is a medical procedure used to evaluate the rate at which food leaves the stomach. It is a valuable diagnostic tool for conditions affecting the stomach and digestive system, such as gastroparesis, pyloric stenosis, and diabetic gastroparesis. This comprehensive guide will delve into the CPT code for GES, its indications, preparation, procedure, interpretation, and clinical applications.

CPT Code for Gastric Emptying Study

The CPT code for a gastric emptying study is 91214. This code represents the professional services rendered by a healthcare provider for performing and interpreting the GES, including the administration of a radioisotope or tracer meal, monitoring, and data analysis.

Indications for Gastric Emptying Study

A gastric emptying study is indicated in patients with symptoms suggestive of delayed gastric emptying, such as: * Nausea and vomiting * Abdominal pain and bloating * Early satiety * Weight loss Specific conditions that may warrant a GES include: * Gastroparesis, a condition characterized by impaired stomach motility * Pyloric stenosis, a narrowing of the outlet of the stomach * Diabetic gastroparesis, a complication of diabetes that affects stomach function * Surgery or trauma involving the stomach or vagus nerve * Evaluation of gastric dysrhythmias

Preparation for Gastric Emptying Study

Prior to a gastric emptying study, the patient is instructed to: * Fast for 8-12 hours before the procedure * Avoid smoking for at least 4 hours before the test * Inform the healthcare provider of any medications or supplements being taken

Procedure for Gastric Emptying Study

A gastric emptying study typically involves the following steps: * Administration of a Tracer Meal: The patient ingests a meal labeled with a radioisotope or tracer, such as technetium-99m sulfur colloid. * Monitoring and Imaging: The patients stomach is monitored using a gamma camera or other imaging device over several hours. * Data Analysis: The images are analyzed to calculate the gastric emptying rate, which indicates the time taken for 50% of the tracer meal to leave the stomach (T½).

Interpretation of Gastric Emptying Study

The normal range for gastric emptying varies depending on the type of meal consumed. However, a T½ of more than 90 minutes for a solid meal or 60 minutes for a liquid meal is generally considered delayed.

Clinical Applications of Gastric Emptying Study

A gastric emptying study provides valuable information for: * Diagnosing Gastroparesis: Delayed gastric emptying is a key feature of gastroparesis. A GES can confirm the diagnosis and assess the severity of the condition. * Evaluating Pyloric Stenosis: A GES can detect pyloric stenosis by showing delayed emptying through the narrowed outlet of the stomach. * Monitoring Diabetic Gastroparesis: A GES can help monitor the progression and response to treatment in patients with diabetic gastroparesis. * Assessing Gastric Motility Disorders: A GES can identify gastric dysrhythmias, such as tachygastria or bradygastria, which can affect gastric emptying. * Evaluating Postoperative Gastric Function: A GES can assess stomach function after surgery involving the stomach or vagus nerve.

Case Studies

Case Study 1: A 35-year-old woman presented with nausea, vomiting, and abdominal pain after every meal. A gastric emptying study revealed delayed gastric emptying, leading to the diagnosis of gastroparesis. Medication and dietary modifications improved her symptoms. Case Study 2: A 2-year-old child with pyloric stenosis experienced projectile vomiting. A gastric emptying study showed severe delay, confirming the diagnosis. The child underwent successful surgery to correct the narrowing. Case Study 3: A 60-year-old man with diabetes complained of poor appetite and weight loss. A gastric emptying study indicated diabetic gastroparesis, and insulin optimization and dietary recommendations helped alleviate his symptoms.

Conclusion

The gastric emptying study (CPT code 91214) is a valuable diagnostic tool for evaluating gastric emptying rate. It aids in the diagnosis and management of various conditions affecting the stomach and digestive system. By providing objective data on stomach function, a GES assists healthcare providers in optimizing patient care and improving outcomes.

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