# Capsule Endoscopy - I am interested to know



## bbeatty (Aug 4, 2010)

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!


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## Lisa Bledsoe (Aug 4, 2010)

bbeatty said:


> 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.


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## bbeatty (Aug 5, 2010)

Lisa Curtis said:


> 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.


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## Lisa Bledsoe (Aug 5, 2010)

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...


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## rcclary (Aug 5, 2010)

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


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## Lisa Bledsoe (Aug 6, 2010)

rcclary said:


> 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.


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## QueensCoder (Feb 8, 2013)

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.


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## medcoders (Feb 27, 2013)

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...


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