September 1, 2016
How do I bill for the Bravo placement? I’m coding an EGD with 43235 and the Bravo code, 91035 but getting denied.
Great question and one that came up at a recent ACS coding course! First, if endoscopy is performed to evaluate the underlying problem, this is coded as a diagnostic EGD endoscopy, 43235. If something therapeutic is performed during the endoscopy, for example a biopsy, the appropriate therapeutic endoscopy code would be reported. The Bravo capsule code, 91035 Esophagus, gastroesophageal reflux test with mucosal attached pH electrode placement, recording, analysis and interpretation, should be reported and the date Bravo capsule is removed a few days after placement. Also, if an EGD for diagnostic or therapeutic purposes was done previously and already diagnosed the problem, it would not be appropriate to report it with a subsequent Bravo placement.
*This response is based on the best information available as of 09/01/16.