kim cpc
Guest
I'm needing assistance in regards to a denial received for a 43248 and a 43239,2 51. UHC is stating that the 43248 is an integral part because of it being in the same family, they state their following cms guidelines and were billing with the wrong modifier, they also state 59 is not the proper one either so Im curious to see how to properly code this for reimbursement, our medicare patients clms are being paid each separately using the 51. Any help would be greatly appreciated.
Scenario:
No gross lesions noted in entire esophagus. Bx were taken with cold forceps. a guidewire was placed and scope was withdrawn. A 45 Fr. Savary dilator was passed over the guidewire. Dilation was performed for subtle strictures that were not evident on endoscopic exam.
The Z-line was found 39cm from the incisors. BX were taken for histology.
Localized erythematous mucosa with no bleeding was found in the cardia. BX wer taken with cold forceps.
PATH:
GASTRIC BX;
minimal chronic gastritis
DISTAL ESOPHAGUS BX
squamo-cardiac junction mucosa with chronic inflammation
negative for Barretts
ESOPHAGUS, MID, BX
stratisfied squamous epithelium with mild reactive changes
How would you code this out for proper reimbursement any help will be greatly appreciated.
Scenario:
No gross lesions noted in entire esophagus. Bx were taken with cold forceps. a guidewire was placed and scope was withdrawn. A 45 Fr. Savary dilator was passed over the guidewire. Dilation was performed for subtle strictures that were not evident on endoscopic exam.
The Z-line was found 39cm from the incisors. BX were taken for histology.
Localized erythematous mucosa with no bleeding was found in the cardia. BX wer taken with cold forceps.
PATH:
GASTRIC BX;
minimal chronic gastritis
DISTAL ESOPHAGUS BX
squamo-cardiac junction mucosa with chronic inflammation
negative for Barretts
ESOPHAGUS, MID, BX
stratisfied squamous epithelium with mild reactive changes
How would you code this out for proper reimbursement any help will be greatly appreciated.