Results 1 to 8 of 8

Capsule Endoscopy - I am interested to know

  1. #1
    Default Capsule Endoscopy - I am interested to know
    Exam Training Packages
    I am interested to know how others are billing their capsule endoscopies when placed endoscopically. I know that the EGD should be billed, but we have been billing 91110-52 for the capsule reading with some success. If anyone else does this, can you tell me when you bill for the reading, do you bill the date of capsule placement or the date of the reading??? Thanks in advance for your help!

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Quote Originally Posted by bbeatty View Post
    I am interested to know how others are billing their capsule endoscopies when placed endoscopically. I know that the EGD should be billed, but we have been billing 91110-52 for the capsule reading with some success. If anyone else does this, can you tell me when you bill for the reading, do you bill the date of capsule placement or the date of the reading??? Thanks in advance for your help!
    Why are you using mod -52?
    We bill 91110 on the date of interpretation. It should not be billed for on the date of placement because the test is not complete at that time. 91110 should only be billed once and that is for the date of interpretation.
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Default
    Quote Originally Posted by Lisa Curtis View Post
    Why are you using mod -52?
    We bill 91110 on the date of interpretation. It should not be billed for on the date of placement because the test is not complete at that time. 91110 should only be billed once and that is for the date of interpretation.
    This is what I was given from the Capsule billing representative:


    guidance from the AGA regarding endoscopic CE placement:

    Coding Question
    “On occasion, a patient may have difficulty swallowing the capsule endoscope for the intraluminal imaging of the esophagus through the ileum. The physician elects to place the capsule into the stomach endoscopically. How do we code for the placement and the capsule?”

    Since the capsule will not be taking images of the esophagus and part of the stomach, code 91110-52 for the capsule, which identifies an abbreviated procedure, and 43235 for the upper endoscopy. Even if the capsule is placed in the esophagus endoscopically, you cannot get paid twice for performing the same procedure, namely viewing the esophagus and the stomach.

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Thank you for that information! The only info I had was if it didn't view the ileum we should add -52. I need to get this corrected asap...
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Default
    We bill for the interpretation and use 91110-26 and use the date the capsule was place or swallowed.

  6. #6
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Quote Originally Posted by rcclary View Post
    We bill for the interpretation and use 91110-26 and use the date the capsule was place or swallowed.
    The problem for us is that we purchase the capsules, so our docs are doing this as global.
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Red face
    I was wondering why they were doing an EGD and the capsule also. That was a great info. I will always you the date of the interpretation for the capsule, because you never know.. you might not get it back (lol).
    For the EGD the day its was place.

  8. Default
    code 43235-52 for the placement of the capsule due to where its being placed
    91110 includes interpretation right? 91110-52 is interpretation from the origin where it started since not the esophagus...

Similar Threads

  1. Capsule Endoscopy
    By aryanah in forum Gastroenterology
    Replies: 0
    Last Post: 03-23-2015, 06:18 AM
  2. Capsule Endoscopy - Our doctors want to start
    By ohsuziqu in forum Gastroenterology
    Replies: 0
    Last Post: 01-08-2015, 10:52 AM
  3. Capsule Endoscopy
    By hcg in forum Gastroenterology
    Replies: 8
    Last Post: 09-06-2012, 08:07 AM
  4. Endoscopy Capsule
    By elenax in forum Outpatient Facilities
    Replies: 1
    Last Post: 09-29-2010, 08:40 PM
  5. Capsule Endoscopy - What is the difference
    By rhaney88 in forum Gastroenterology
    Replies: 2
    Last Post: 10-29-2009, 12:50 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.