How should I code for a Flex Sig with Bougie Dilator, NOT balloon dilator of a rectal stricture that is 15 cm beyond the anal verge??? Should I bill 45340, flex sig w/dilation and add 22 modifier to cover the bougie dilation over guidewire? Originally thought to bill a 45910, but the physician said that particular dilator used for 45910 procedure wouldn't reach the stricture.