Has anyone coded for ph probe placement cpt 91035? It is for a reflux text via a ph electrode and includes placement,recording,analysis and interpretation. Physician also did biopsies so I can code 43239, but I'm wondering whether I can code 91035. Is this something ASC's can bill for? Perhaps it's billed with a modifier-TC? Any clarification would be great!
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Wiki pH probe placement-endoscopic cpt 91035
- Thread starter ncantello
- Start date
Anna Weaver
Guest
ph probe
This is the lay description:
The physician performs a gastroesophageal reflux test using mucosal attached telemetry pH electrode placement and recording. A small capsule containing a radiotelemetry pH sensor is inserted endoscopically in the esophagus and temporarily attached to the esophageal wall. The capsule monitors esophageal pH levels over a 48-hour period. This information is transmitted to an external pager-sized receiver worn by the patient that records pH levels. After the 48-hour testing period, the data is downloaded from the receiver to a computer that contains software for analyzing pH levels. The physician provides a written interpretation of the computer analysis. The capsule does not need to be removed as it spontaneously detaches within seven to 10 days and passes through the digestive tract.
When I did the coding for the facility, I did not code these at the time of insertion, they are inclusive to the EGD procedure. But when the patient returned to the facility to have this read, they would then order the 91035 and there wouldn't be a problem with inclusion as it was 2 days later. Not sure what the reimbursement rate was as I never saw that end of it.
Anyone else?
This is the lay description:
The physician performs a gastroesophageal reflux test using mucosal attached telemetry pH electrode placement and recording. A small capsule containing a radiotelemetry pH sensor is inserted endoscopically in the esophagus and temporarily attached to the esophageal wall. The capsule monitors esophageal pH levels over a 48-hour period. This information is transmitted to an external pager-sized receiver worn by the patient that records pH levels. After the 48-hour testing period, the data is downloaded from the receiver to a computer that contains software for analyzing pH levels. The physician provides a written interpretation of the computer analysis. The capsule does not need to be removed as it spontaneously detaches within seven to 10 days and passes through the digestive tract.
When I did the coding for the facility, I did not code these at the time of insertion, they are inclusive to the EGD procedure. But when the patient returned to the facility to have this read, they would then order the 91035 and there wouldn't be a problem with inclusion as it was 2 days later. Not sure what the reimbursement rate was as I never saw that end of it.
Anyone else?
mbort
True Blue
it does qualify for the TC modifier..I say go for it..let us know what happens 