General Surgery Coding Alert

Question: Our office just purchased equipment so we can conduct in-office M2A Capsule tests. What is the best way to report M2A Capsule tests?

Montana Subscriber

Answer: Coding for M2A Capsule tests (during which the patient swallows a small capsule that sends pictures of the intestinal tract to a recording device) used to depend entirely on the insurance carrier. But in 2004, CPT added a code for M2A Capsule tests.
 
When the surgeon performs an M2A Capsule test, you should report 91110 (Gastrointestinal tract imaging, intraluminal [e.g., capsule endoscopy], esophagus through ileum, with physician interpretation and report). Here's more info on the new M2A Capsule code:

 

Most insurers will accept 91110, but you should check with an insurance representative before using the code the first time.

 

When reporting only the technical portion of the M2A Capsule test, use 91110 and attach modifier -TC (Technical component).

 

When reporting only the professional component of the M2A Capsule test, use 91110 and attach modifier -26 (Professional component).

 

CPT added Crohn's disease to its list of approved indications for M2A Capsule test. More approved indications are expected in the next few years.