Wiki CPT 43229 & device code

[jules0024]

Hi,
We had a patient come in for upper endoscopy with photodynamic therapy. We billed 43229 but the insurance keeps denying it saying it is device dependent procedure. According to our ENDO supervisor, there was no device used. Any suggestions would be helpful.

Thank you
Julie

 

[thomas7331]

I believe that to bypass the device-dependent edit for a facility claim you will need to append modifier CG to the code to indicate that no device was used in that particular procedure.

 

[jules0024]

We have already filed the claim with the CG and without it. Both were denied.