Billing and Coding: Wireless Capsule Endoscopy

Wireless capsule endoscopy is billed with CPT 91110 for small-bowel or esophagus-through-ileum studies and CPT 91111 for esophagus-only studies; a dual diagnosis is required. Coverage requires documentation that prior colonoscopy/endoscopy did not identify the bleeding source, that the patient is not a candidate for conventional endoscopy with specific comorbidities documented, and that the capsule study will contribute to patient care; all claims must meet LCD L33774 and CMS policy requirements.

"Wireless capsule endoscopy of the small bowel (including esophagus through ileum) is billed with CPT 91110 when clinically indicated."

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