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Wiki Bx 43239 and Ablation 43258

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Mklaubauf

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If we took a biopsy prior to ablated Barrett's epithileum, can I code both 43239 & 43258?

Thank you
Marci
 
When my provider first started doing ablation for Barrett's, he also would biopsy and then ablate and I billed both for quite some time. Then we started getting denials on the 43239 from a commercial payer (can't remember who). When I researched furher, I worried that the 43239 was not billable, because the results of the bx weren't being used to determine the next stage of treatment, so the same site rule would apply. The ablation was happening before the bx results were even back. During that investigation, I contacted our equipment Rep for guidance. I was told by our Rep that the provider should not bx right before an ablation anyway. Something to do with how the freshly biopsied tissue would react with the current, or some other jargon I don't now remember. Anyway, after that discussion, our rep met with my provider and since then, he never biopsies in the same session.
 
Bridgette,

Nice explanation. I'll keep this in mind when/if I run across it. And I agree even though I said CCI didn't show there being a problem. The whole "same site" rule being a good guiding factor.
 
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