Gastroenterology Coding Alert
Fearlessly Report EGD and PillCam® Capsule Together
Question: Can we bill for a capsule placement by doing an EGD in an ASC and get reimbursement? The purpose of the EGD was primarily for the placement of the capsule as the patient was unable to swallow the capsule for some reason. If it is possible, what would I code?
Wyoming Subscriber
Answer: Yes, you may bill for an EGD and a capsule placement together. An EGD with placement of the PillCam® through the pylorus is not unusual in patients with diminished gastric motility or a stenosis of the distal esophagus or pyloric channel. In your case, if you used it to view the small intestine down through the ileum, you should report 91110 (Gastrointestinal tract imaging, intraluminal [eg, capsule endoscopy], esophagus through ileum, with interpretation and report). You should also bill 43235 (Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]).
Gastroenterology Coding Alert
- GI Tract Imaging:
Smoothen Out Your Capsule Endoscopy Wrinkles With These Tips
Watch out for new code 0355T for colon imaging. Your gastroenterologist has just recommended that [...] - Don't Let Modifier Glitches Sideline Your Capsule Endoscopy Claims
Ask for pre-authorization from the carrier to repeat a capsule study due to previous technical [...] - Audit Alert:
Heed These Documentation Cues to Avoid Audit Gaps
Pass the four-pronged test employed by CERT reviewers. You don’t want to be on an [...] - ICD-10 Update:
Direct Matches Simplify Your Noninfectious Gastroenteritis Reporting
Focus on the cause for arriving at the right ICD-10 code. If your gastroenterologist diagnoses [...] - Readers Question:
Go to G0472 for Reporting Hepatitis C Screening
Question: Our GI just saw a Medicare patient and advised her to undertake a hepatitis C [...] - Readers Question:
Check Off These Conditions to Justify Consult Visit
Question: Our GI attended to a new patient. She said that she was advised by her [...] - Reader Question:
Fearlessly Report EGD and PillCam® Capsule Together
Question: Can we bill for a capsule placement by doing an EGD in an ASC and [...] - Reader Question:
Check Payer for Exact Rules on Botox Injection Rules
Question: My physician’s documentation states that he performed esophagoscopy with Botox and Savary dilation. Can you [...] - You Be the Coder:
Watch Out For 90-Day Global for Hemorrhoid Procedure
Question: Our gastroenterologist saw a patient in the office visit with subsequent advice to perform IRC. [...]
