Lowdown on New M2A Video Capsule:
Three Options for Reporting
Published on Tue Jan 01, 2002
Although Given Imaging's M2A Video Capsule System is the hot new technology for diagnosing gastrointestinal disorders, gastroenterologists who perform the procedure must be prepared to go through the hassle and uncertainty that comes with reporting a new technology to insurers. There are a variety of codes used to report the M2A capsule, and gastroenterologists will probably have to precertify the procedure and file manual claims in order to provide extra information to payers.
"As with most new procedures, the initial gastroenterologists who use the M2A capsule will have to deal with claims that require extra work and may not always be compensated properly for it," says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and a former member of the CPT advisory panel. "It will take one or two years before carriers and payers get everything worked out. Doctors don't like to wait that long, but they'll have to get used to that fact."
M2A Requires Substantial Physician Time
The M2A capsule is a noninvasive technique for visualizing the entire small bowel including the distal ileum, which is difficult to observe with standard endoscopes, says Cheryl Soderholm, director of reimbursement at Given Imaging. The capsule was approved for use by the Food and Drug Administration on Aug. 1, 2001, and is intended for the visualization of small bowel mucosa as an adjunctive tool in the detection of abnormalities of the small bowel.
The M2A system requires three components:
1. the M2A capsule endoscope, a disposable, swallowable capsule that captures video images as it is naturally propelled through the digestive system
2. an external data recorder and sensor array that receive data transmitted
by the capsule
3. a modified standard computer that acts as a workstation for the storage, interpretation and analysis of the acquired images and for generating reports.
During the procedure, the array of sensors is placed on the patient, who is also fitted with a belt to hold the external recorder. After the patient is given the capsule to swallow, he or she can resume a regular schedule of activities while the capsule travels through the digestive tract during the next seven to eight hours. The capsule is eventually excreted naturally. The video images in the recorder are then downloaded to the workstation. Once the download is complete, the gastroenterologist has approximately 50,000 images to review and interpret. Depending on the complexity of the patient's condition and the gastroenterologist's level of experience, the review could take from 30 minutes to two hours.
As they become more comfortable with the procedure, gastroenterologists may have a staff member assist with tasks such as the placement of the sensors, Soderholm reports. In addition, a staff member is usually responsible for downloading the data from [...]
