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A9268 Programmer orally ingest cap

A Codes

Also known as: programmable capsule, smart pill, electronic capsule

Ingestible capsule with programmable technology for oral administration and monitoring.

In Plain Language

swallowable electronic device; smart medicine pill; tracking capsule

Clinical Context

Used for gastrointestinal monitoring and data collection in specialized clinical applications. Advanced technology for non-invasive monitoring.

RVU Information

CPT A9268 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.

Billing & Documentation

HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.

Specialties

GastroenterologyExperimental MedicineInternal Medicine

Frequently Asked Questions

What is CPT code A9268?

CPT A9268 (Programmer orally ingest cap) is a A Codes code. Ingestible capsule with programmable technology for oral administration and monitoring.

Does Medicare cover A9268?

Medicare coverage for A9268 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used for gastrointestinal monitoring and data collection in specialized clinical applications. Advanced technology for non-invasive monitoring. A physician order is typically required.

When is CPT A9268 used?

Used for gastrointestinal monitoring and data collection in specialized clinical applications. Advanced technology for non-invasive monitoring.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.