Gastroenterology Coding Alert

Question: If our gastroenterologist administers a capsule endoscopy in the office, does 91110 include the cost of the capsule, or is it separately billable?-Also, if the gastroenterologist places the capsule in our clinic's own endoscopy suite (ASC classification) in conjunction with an EGD, will payers cover 91110 with place of service 24?

Alabama Subscriber

Answer: Code 91110 (Gastrointestinal tract imaging, intraluminal [e.g., capsule endoscopy], esophagus through ileum, with physician interpretation and report) includes the capsule and the reading and interpretation.

Heads-up: If your gastroenterologist only places the capsule, you'll report 91110-TC (Technical component). If your gastroenterologist only does the interpretation, you'll report 91110-26 (Professional component). If your gastroenterologist performs both, you'll report 91110 with no modifiers.

Place of service (POS): It is only paid when the gastroenterologist performs this procedure in the office (POS 11). If you report 91110 with POS 24, insurers won't cover the capsule procedure.