Patency Capsule Coding

clarkmegan

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Local Chapter Officer
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Newport News
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Is anyone billing for Patency Capsules? I have older coding guidance that states to bill 91299, however I can not find any updated clear guidance to say whether or not this code is still appropriate. If you are billing for the patency capsule, what CPT/HCPCS codes are you using?
 

zcometa

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Santa Rosa
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Capsule patency

Is anyone billing for Patency Capsules? I have older coding guidance that states to bill 91299, however I can not find any updated clear guidance to say whether or not this code is still appropriate. If you are billing for the patency capsule, what CPT/HCPCS codes are you using?

https://www.uhcprovider.com/content...ies/medadv-guidelines/c/capsule-endoscopy.pdf

http://www.aetna.com/cpb/medical/data/500_599/0588.html

UHC has the capsule patency CPT as 91299 and considers it investigational. You can do an ABN and bill the insurance knowing that it may not be a covered benefit.
 
Last edited:

kayba89

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Reno, Nevada
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Is anyone billing for Patency Capsules? I have older coding guidance that states to bill 91299, however I can not find any updated clear guidance to say whether or not this code is still appropriate. If you are billing for the patency capsule, what CPT/HCPCS codes are you using?
We do not bill for patency capsules. They're just blank capsules to see if the patient can swallow the real capsule. If they can't they schedule them for an EGD to place the capsule. Which then we bill the capsule with a -52.
 
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