Hello, I am interested to hear how other coders are addressing this sticky area. We own the capsules, so when swallowed in office we bill global. However, in some instances our physicians have elected to place them endoscopically. So we have billed 43235 – 52(if the scope is not advanced to the duodenum) in the instance that a patient would be unable to obtain adequate deglutition due to dysphagia, with 91110-52 on the date of interpretation due to the fact that the esophagus is not captured on capsule images.

Currently, we have a case where the patient suffers from crohn’s disease which requires staging, but also has gastroparesis. Due to concern of the capsule not advancing they want to go in and advance it manually after the capsule is swallowed. I believe we could bill 43235 on date of EGD and 91110 (if capsule reaches the ileum) on date of interpretation. I see no CCI edit that would prevent it, but I have never tried to bill a capsule and an EGD same day.

Does this seem correct? Please share any insight or red flags you see. Thank you so much!