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Don’t Let Modifier Glitches Sideline Your Capsule Endoscopy Claims

Posted on 08. Apr, 2015 by in Hot Coding Topics

Ask for pre-authorization from the carrier to repeat a capsule study due to previous technical problems.

Reporting capsule endoscopy is not just about knowing the procedure codes and when to use them. It is also about being proficient enough to report interrupted procedures, delayed procedures, or other such contingencies. Remain on top of these situations armed with the knowledge of the correct modifiers.

If you are reporting only the professional component for your capsule endoscopy services ((i.e., interpretation and report of the results), you should append professional component modifier 26 (Professional component) to the appropriate code. For example, if your physician is part of a facility, and the facility owns the equipment used for the endoscopy, the gastroenterologist will only report the professional component.

When you are reporting only the technical component for the service, append technical component modifier TC to the code unless the hospital provided the technical...

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