Anyone Using Capsule Colonoscopies?


Warrenton, MO
Best answers
Just Wondering If Anyone Is Using This In The Office? How It Is Working? And How Is The Reimbursement From The Payors? Thanks.
Open Access Capsule

Hi, I'm Kathleen, lead biller for a year and in billing for 2 and half years. We have been using the capsules for about 4 years now. The test is successful as far as finding a hidden GI Bleed, but we formerly had been just scheduling these tests from another doctors referral. In the past few weeks, we are no longer doing this but have a office visit prior to the capsule. There were many times a patient would have the capsule that later the GI' physician would feel they originally did not need the test. The capsule endo is not part of a global per medicare so the E/M visit is separately billed.

They payors all have specific requirements as far as ICD-9 codes. But, we are readily reimbursed 95% of the time without a problem other than sending office notes and test results, labs, ect., also.
When the capsule is being done because there is a suspected bleed but the other tests were normal, what DX are you using ?