ASGE members may submit coding inquiries electronically to codingquestions@asge.org. Each month ASGE gets dozens of questions from members. 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 not reports. Below are two questions that could be beneficial to your practice.
Question #1
Our question is about the place of service for manometry, CPT code 91010 and pH studies. The technical component is being done in an out-patient hospital facility (place of service code 22). The technical component is of course being billed separately by that entity with a TC modifier. Our gastroenterologists are doing the interpretation or professional component from our office location, and we do the billing for that with modifier 26. The question is, should the professional component be billed with the place of service code 22 for the out-patient location where the actual test was performed, or place of service code 11 for the interpretation which is being done in our office but with no face-to-face contact with the patient?
Answer
The interpretation must be billed under place of service code 22 for outpatient hospital since that is where the test was originally performed.
Question #2
What is the CPT code for an enteroscopy done via the rectal approach?
Answer
This would be billed as an unlisted procedure, and you can find this information in your CPT book. The unlisted procedure is CPT code 44799, and you can use RVU's comparable to CPT code 44360.