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Gastroenterology Coding Alert

Reader Question:

M2A Capsule Coding No Longer a Pill

Published on Wed Jul 07, 2004

Question: Our office just purchased equipment so we can conduct in-office M2A Capsule tests. What is the best way to report M2A Capsule tests?

Montana Subscriber

Answer: Coding for M2A Capsule tests used to depend entirely on the insurance carrier. But in 2004, CPT added a code for M2A Capsule tests. When the gastroenterologist performs an M2A Capsule test, you should report 91110 (Gastrointestinal tract imaging, intraluminal [e.g., capsule endoscopy], esophagus through ileum, with physician interpretation and report). More info on new M2A Capsule code 91110:

  • 91110 will be accepted by most insurance carriers, but check with an insurance representative before using the code for the first time.
  • When reporting only the technical portion of the M2A Capsule test, use 91110 and attach modifier -TC (Technical component).
  • When reporting only the professional component of the M2A Capsule test, use 91110 and attach modifier -26 (Professional component).
  • CPT added Crohn's disease to its list of approved indications for M2A Capsule test. (More approved indications are expected in the next few years.)

    -- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, coding and billing coordinator for GI Diagnostic Endoscopy Center in Marietta, Ga.

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