Wiki Endoscopy and Bravo tube placement

[NESmith]

For this procedure we billed a 43235-59 and 91035. The insurance company is denying the 43235 as inclusive even with the 59 modifier. The op-report reads: The Olympus video endoscope was advanced to the descending duodenum. Endoscopic Findings: Descending duodenum is normal. Duodenal bulb is normal. Pylorus is normal. Antrum is normal. Body is normal. Fundus is normal. There is some retained gastric content noted. Pt has a hiatal henria. At 31 cm, a Bravo ph probe was placed without difficulty. The remainder of the esophagus is normal. Was this denied correctly? Thanks

 

[Lisa Bledsoe]

You can't code 91035 until after the physician interprets and it will be billed with the office as the POS. Don't bill 91035 and 43235 at the same visit.