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Endoscopic - Does anyone do this procedure

  1. #1
    Default Endoscopic - Does anyone do this procedure
    Medical Coding Books
    Hello. Does anyone do this procedure, and if so what do you charge / get reimbursed? The American Acedemy of Oto reccommends using the Unlisted code 43499. The comparable open procedure is 43130.

    Thanks!
    Teresa

  2. #2
    Location
    Tuscaloosa, AL
    Posts
    92
    Default
    We did this once about 2 years ago and billed 43499. Medicare (Alabama) only allowed $721.
    Jerri, CPC

  3. #3
    Default Zenker's
    what code do you compare the fee to? I have previously used 43216 and that is $439 which doesn't quite seem like enough and sounds like you are billing higher...

    Thanks!
    Teresa

  4. #4
    Default Zenker's
    Forgot to say...I'm in Kansas, and the technique used was stapling....

    thanks so much for the info I really appreciate it!

    Teresa

  5. #5
    Location
    Tuscaloosa, AL
    Posts
    92
    Default
    My doctor used the stapler, too. Medicare crosswalked my unlisted code to 43130 (diverticulectomy - cervical approach) after reviewing the operative report and paid at that rate. I based my fee on that code, luckily, so it worked out pretty well.
    Jerri, CPC

  6. #6
    Default zenkers
    I am really surprised they compared it to the open procedure because the endoscopic one is considered much easier. Thanks for the information tho it really helped!

    Teresa

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