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.