ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and no reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.
Question: Can you please confirm whether an EGD performed solely for capsule placement is included in the capsule endoscopy and not separately billable, while a medically necessary diagnostic EGD performed for a separate indication may be billed separately? Also, if the capsule is placed at an ASC but interpreted in the office, should the place of service be reported as the ASC?
Answer: If the EGD is performed only to assist with capsule placement or advancement, it is not separately billable because it is considered part of the capsule endoscopy procedure.
If the physician performs a medically necessary diagnostic EGD for a separate clinical indication, in addition to the capsule endoscopy, the EGD may be separately billable when the documentation supports the separate procedure and its medical necessity.
For place of service, the capsule procedure should be reported based on where the procedure is performed. If the capsule is placed at an ASC, the ASC would be the appropriate place of service, even if the physician interprets the capsule images in the office.