91065 expanded to include more breath hydrogen tests

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article provides a brief Medicare and CPT coding update for gastroenterology practices. It explains that a breath hydrogen test code was revised to encompass a broader set of breath testing uses, contrasts that code with an unlisted gastroenterology procedure code discussed in the same context, and notes related coverage and valuation issues raised in comments to CMS. It is most relevant to coders, billing staff, compliance teams, and gastroenterology practices tracking code definitions, coverage policy, and payment impacts.

Why This Topic Matters

The update affects how providers understand the scope of a commonly referenced gastroenterology procedure code and highlights differences between covered and noncovered services. It also flags potential reimbursement implications that may influence coding and billing workflows.

What You Will Learn

  • How a gastroenterology breath hydrogen testing code was updated in broad terms
  • How the article distinguishes a listed procedure code from an unlisted gastroenterology code
  • What general Medicare coverage and payment concerns were raised in connection with the update
  • Why specialty society comments to CMS may matter for coding and reimbursement planning

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance professionals
  • Gastroenterology practices
  • Revenue cycle teams
  • Healthcare administrators

Codes Discussed


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