EGD-Multiple Procedures

[aschaeve]

Can you bill cpt code 43239-EGD with biopsy and 43248-EGD-insertation of guidewire with dilation? If yes, please provide supporting documation.

Thank you,

Alicia CPC

 

[clarkmegan]

Yes, as long as they are on different sites. If the bx is performed where the dilation occurred, then no you can't. Per CCI edits, 43239 is bundled with 43248 but a -59/XS modifier is allowed on 43239 if it is a separate site.

 

[aschaeve]

Thank you, but do you have supporting documentation that says you cannot bill both on the same site?

 

[clarkmegan]

Thank you, but do you have supporting documentation that says you cannot bill both on the same site?

Medicare CCI edits is the supporting documentation. The two codes are bundled together.

 

[aschaeve]

Thank you, but is there anywhere else, besides NCCI that states that these 2 codes cannot be billed together when performed on the same site?