sharjwagner
New
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?
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Wiki 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
- Thread starter sharjwagner
- Start date
Pam Warren
True Blue
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.
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.
sharjwagner
New
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
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?
Pam Warren
True Blue
You'd bill globally....don't split the -26 and -TC on two lines. Just the single code, no modifiers.