Gastroenterology Coding Alert

Question: Our gastroenterologist performed an endoscopy to the duodenum. He found a mild Schatzki ring (acquired) in the gastroesophageal junction. He dilated it with a 50Fr Maloney dilator. Do I code the dilation separate from the EGD?New Mexico SubscriberAnswer: Use 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) for the endoscopy. Use 43450 (Dilation of esophagus, by unguided sound or bougie, single or multiple passes) for the Maloney dilation.Don't append modifier 59 (Distinct procedural service) for the dilation; the Correct Coding Initiative (CCI) does not bundle 43450 into 43235. If the gastroenterologist performed the dilation with a guide wire, use 43248 (... with insertion of guide wire followed by dilation of esophagus over guide wire). If the doctor performed a balloon dilation, use 43249 (... with balloon dilation of esophagus [less than 30-mm diameter]).