Gastroenterology Coding Alert

Question: We want to perform esophageal manometry tests in our clinic. Now that we have our own equipment, should we bill for the test using 91010-26 and 91010-TC or with just the global code, 91010?

Tennessee Subscriber

 
Answer: A gastroenterologist can bill for the technical component when he or she owns (or partially owns by being a partner in a practice) the equipment being used. In your case, you can report both the technical and professional components when the physician interprets the results of a patients manometry test by using global code 91010 (esophageal intubation and collection of washings for cytology, including preparation of specimens [separate procedure]) without any modifiers.
 
The professional component represents the physicians interpretation of the test results, says Linda Parks, MA, CPC, lead coder at Atlanta Gastroenterology Associates, a 23-physician practice. When the gastroenterologist only  interprets the manometry results, as your doctors used to do, he or she may bill for the professional component by attaching modifier -26 (professional component) to 91010.
 
The technical component represents the value assigned to the ownership and maintenance of the equipment and the use of any technicians. If the manometry is done in a hospital, then the hospital bills for the technical component by attaching modifier -TC (technical component) to the manometry code.