Has anyone else in an ASC setting ever billed for an EGD with EMR (endoscopic mucosal resection) of a hemi-cercumferential area of distal barrett's due to intramucosal carcinoma? Please note that the devices is used by applyng a band to create a berry-like pseudopolyp which is then removed by snare. This device costs as much as what Medicare pays for a normal EDG by Snare CPT 43251? According to coding guidelines ASC's are not allowed to use the 22 modifier to increase fees due to the cost of the device. Do you know if there is a HCPC code for this device (not an implantable supply)? Or would it be appropriate to bill unlisted CPT 43289 by report?