Part B Insider (Multispecialty) Coding Alert

Published on Wed Apr 27, 2011 PDF

Question: When coding for a video capsule endoscopy (91110 or 91111), should we bill for the date the capsule was swallowed, or for the date the actual report was read by the gastroenterologist? My GI reads and submits the report/billing several weeks after the patient has actually swallowed the capsule. Could you provide more insight on this?

Minnesota Subscriber

Answer: In general, the date of service for the video capsule endoscopy should be the date the capsule was swallowed even if the provider doesn't send the claim for a few days while she completes the review and report. Most patients will return the recorder later on the same date so that there will be verification of data capture within 24 hours.

If the gastroenterologist sees the patient at a hospital outpatient department, then it is even more important to coordinate the professional reading service for the capsule study -- 91110 (Gastrointestinal tract imaging, intraluminal [e.g., capsule endoscopy], esophagus through ileum, with physician interpretation and report) appended by 26 (Professional component) -- on the same date used for the technical services by the hospital -- 91110 appended by TC (Technical component).