Wiki Capsule Endoscopy

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hcg

hcg

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This would be my first time to code capsule endoscopy & I need help on this one:

Findings & Procedure:
The capsule was swallowed without difficulty and transit was rapid through the esophagus and stomach int he duodenum and small bowel. However, the capsule did not reach the cecum at the end of exam, after more than 7 hours; it appeared to be in the distal terminal ileum. Two vascular lesions were noted in the mid and distal duodenum, the first is perfectly round and appears to be residual from a recent biopsy, the second is linear and truncated and appears to be an actual lesions which could cause bleeding/blood loss.

Summary:
Two significant vascular lesions are seen in duodenum and a few tiny vascular-type are seen in jejunum & ileum. These could be the cause of blood loss; they appear to be random, age related telangectasia type lesions.

Any takers?
 
What were the indications for doing the capsule? You would start with those. Also, is your physician just interpreting the capsule or did your physician or group purchase the capsule?
 
Look at 91110 and 569.84, but yeah you also would want to look at the indications for the procedure. I'm not sure all payers will reimburse for angiodysplasia or telangectasia.

Bob
 
pamsbill said:
What were the indications for doing the capsule? You would start with those. Also, is your physician just interpreting the capsule or did your physician or group purchase the capsule?
Click to expand...

Pt. has iron deficiency anemia, gastritis, history of peptic ulcer disease & had EGD 17 days prior to this procedure. My physician is only interpreting the capsule.

Thank you.
 
blathrop19@gmail.com said:
Look at 91110 and 569.84, but yeah you also would want to look at the indications for the procedure. I'm not sure all payers will reimburse for angiodysplasia or telangectasia.

Bob
Click to expand...


Thank you so much. Pt. had EGD for iron deficiency anemia. Looks like the EGD failed to identify the bleeding source. The payer is Medicare.

I appreciate all your help:)
 
91110 for the CPT and 280.9 and 569.84 for the dx.

My next question is: Did the doctor do all the work at their office and on equipment they owned? If so, no modifier is needed. If not add a 26 modifier if he was just reading the report.
 
coachlang3 said:
91110 for the CPT and 280.9 and 569.84 for the dx.

My next question is: Did the doctor do all the work at their office and on equipment they owned? If so, no modifier is needed. If not add a 26 modifier if he was just reading the report.
Click to expand...


Thank you so much. That's is exactly the codes that I put. Doctor do all the work in the hospital & he is just reading the report, so I put 26 modifier on it.

I appreciate your help & for the guidance :)
 
Yes, Medicare will usually pay for the 280.9.

As others have said, use the 91110-26 for the CPT.
 
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