Sunday, March 13, 2011

Wireless Capsule Endoscopy coding guidelnie

LCD Title
Wireless Capsule Endoscopy

Coding Guidelines

The date of service should be entered as the date of ingestion of the capsule and the date hook-up of the data recorder device was performed regardless of the number of days the recorder is worn. 
Wireless capsule endoscopy of the small bowel should be coded with the CPT code 91110.
For dates of service prior to 01/01/2007:

Wireless capsule endoscopy of the esophagus should be coded with CPT code 91110 and modifier –52.  A dual diagnosis is required when billing for this service.
For dates of service on or after 01/01/2007:
Wireless capsule endoscopy of the esophagus should be coded with CPT code 91111.  A dual diagnosis is required when billing this service.

CPT codes 91110 and 91111 consist of a professional and technical component.

The technical portion (TC modifier) of the service includes:
•    •         provision of the capsule;
•    •         hook-up of the recording equipment;
•    •         downloading of the digital data with processing and creation of video images.
The place of service for the technical component of the test should be reported as the location where the download of the images to the computer is performed.

The professional component (26 modifier) of the service includes review of the images and interpretation with report.

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