Wiki Help with billing Capsule Endoscopy

pcossentino

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Hello fellow AAPC members. We had to let our biller go a few weeks ago and have been struggling to pick up where she left off. I have to bill the following and I am not sure how to prepare the claim.

1. a Capsule Endoscopy done in the hospital - Professional fee only.
2. A Capsule Endoscopy done it the Office. Both the capsule and the professional fee.

The other concern I have is our new doc has starting coding using time. I am nervous about having the appropriate documentation in the chart. Any others that have experience with this that can officer advice I'd be grateful.

Many Thanks
Priscilla Cossentino
 
Hello fellow AAPC members. We had to let our biller go a few weeks ago and have been struggling to pick up where she left off. I have to bill the following and I am not sure how to prepare the claim.

1. a Capsule Endoscopy done in the hospital - Professional fee only.
2. A Capsule Endoscopy done it the Office. Both the capsule and the professional fee.

The other concern I have is our new doc has starting coding using time. I am nervous about having the appropriate documentation in the chart. Any others that have experience with this that can officer advice I'd be grateful.

Many Thanks
Priscilla Cossentino


Professional fee only is 91110 with a modifier of 26.
When it is done in the office and you paid for the capsule, leave the 26 modifier off and you will be billing for both parts of the procedure, the technical and the professional parts.
 
Professional fee only is 91110 with a modifier of 26.
When it is done in the office and you paid for the capsule, leave the 26 modifier off and you will be billing for both parts of the procedure, the technical and the professional parts.

Thank You for your reply !
 
When billing for Capsule Endoscopy you will need to follow payer guidelines, some require a primary diagnosis to state pre-requisites have been met. Most insurance carriers require authorizations before a capsule can be done and want the authorization number on the claim.

Good Luck
 
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