Wiki 91035

[cingram]

code 91035 includes placement,recording and intrepretation of the capsule. The doctor tried to place the capsule twice both unsuccessful. Can I append a modifier -53 to this along with -26 or can I just not code it. this procedure was in addtion to a EGD

 

[dadhich.girish]

Depends; if the patient's wellbeing is on threat, append mod 53, otherwise 52 (reduced service). Of course append mod 26.

 

[cingram]

are you sure to put on modifier 26 the code is placement, recording, analysis and interpretation. I dont think modifier 26 would apply here.

 

[eescalante]

Modifier 26 applies if the physician does not own the equipment. The 91035 code implies reading was done, so I don't think the 52 or 53 apply. Bill the EGD but not the Bravo. Bravos should only be billed by the physician at the time of reading. The HOSPITAL or whomever owns the equipment and pills could bill the 91035 as a reduced or discontinued service with the TC modifier to recoup the cost of the pill. But the physician would not bill it if there was nothing to read.