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Bravo billing for Gastro

Brenda Posted Fri 09th of September, 2011 14:09:41 PM

My doctor bills 91110 often. He does this procedure in the outpatient dept of the hospital. Hospital provides the capsule & any equipment. I have been billing this code with modifier 26 attached. Should I be billing the total component? Where can I find written information on billing so that I can show the provider?

SuperCoder Answered Fri 09th of September, 2011 16:50:05 PM

Code depends on the component of services provided. Plz refer to related info link:(Plz mention, if not accessible).

http://www.supercoder.com/articles/articles-alerts/gac/you-be-the-coder-capture-capsule-endoscopy-reimbursement/?zoom_highlight=91110

Catherine Answered Sat 15th of October, 2011 12:31:08 PM

I see this often in the two facilities where I provide auditing services. The professional component should bill the 91110 code when he reads the results in his office and the facility bills for a 43235 when capsule is inserted.

Carol Answered Fri 28th of October, 2011 14:48:30 PM

I believe this is the wrong code for the Bravo capsule. I believe it should be 91035. The CPT code of 91110 is for the Pill Cam. What procedure are we talking about?

Catherine Answered Sat 29th of October, 2011 02:34:05 AM

You are correct Carol. The Bravo capsule is 91035. That is inserted endoscopically prior to reading after 48 hours.

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