Gastroenterology Coding Alert

Find out CPT, Medicare, private payers' take on 43239 and 43248 claims.If you confuse comprehensive codes with diagnostic (base) codes, you could be leaving crucial codes off your claim or using the wrong modifier, which could result in loss of payment.Make sure your claims are compliant by testing yourself with this example submitted by a Gastroenterology Coding Alert subscriber:Scenario: "The doctor performed an EGD/dilation and biopsy of an esophageal stricture. Would you bill both the 43248 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with insertion of guide wire followed by dilation of esophagus over guide wire) and the 43239 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple) with the appropriate modifier?Or, do you think the "same site" rule would apply, and therefore you should only bill the procedure with the higher relative [...]