?Bill for EGD balloon dilator

cdaigle

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When billing 43249, can you also bill for the balloon itself? We own our ASC and do our procedures here. We usually do those type of dilatations at the hospital, but have started doing them here. The balloons themselves cost $170-$200 each. If I can, is it C1726?
 

jhartwig

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Martinez, CA
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Balloon Dilatator Coding

If the endoscope is removed prior to dilatation, as in over-the-wire dilatation, neither 43220 nor 43249 should be reported.
Instead, the balloon dilation should be reported "separately (eg, 43456 or 43458)," as appropriate, AND a diagnostic endoscopy code (43200 or 43235) would be used for the endoscopic guide wire placement.

The coding would be:
43456
43235-59
 

bethh05

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We consider them a high cost supply and depending on the carrier, we bill 99070.
 
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