• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

We are billing 91110 & 91111 for the capsule endoscopy with the 26 & TC modifiers. However, they are being rejected for improper coding. What is wrong

S

sharjwagner

New
Messages
4
Location
Pala, CA
WE have used 91110 w/26 modifier on one line & then 91110 w/TC on same line. Denied. Then we used 91110 we/26 modifier and 91110 w/TC modifier on separate line. Still denied. Same for 91111. Any ideas?
 
Do you have a CPT book? It specifically says you cannot bill these two codes together. They are global codes and one is through the ilium and the other is esophagus only. The provider is going to read only as far as the capsule travels!

The code includes both the imaging and the report, so you don't split bill them. Bill one or the other, depending on the course of the capsule.
 
Pam Warren said:
Do you have a CPT book? It specifically says you cannot bill these two codes together. They are global codes and one is through the ilium and the other is esophagus only. The provider is going to read only as far as the capsule travels!

The code includes both the imaging and the report, so you don't split bill them. Bill one or the other, depending on the course of the capsule.
Click to expand...
Hi Pam, thanks for your response. We don't bill 91110 & 91111 together. We do use 26 & TC as the modifiers because he also reads the report as well. We've billed 26 & TC both together and as separate lines and 2 lines w/one having 26 mod & the next w/TC modifier. All are being denied. Do you have any suggestions? Thanks very much
 
sharjwagner said:
Hi Pam, thanks for your response. We don't bill 91110 & 91111 together. We do use 26 & TC as the modifiers because he also reads the report as well. We've billed 26 & TC both together and as separate lines and 2 lines w/one having 26 mod & the next w/TC modifier. All are being denied. Do you have any suggestions? Thanks very much
Click to expand...

Are the services being performed and billed by the same provider? If so, wouldn't you just bill the global service, versus the 26 and TC?
 
You must log in or register to reply here.
Top