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Thread: EGD with esoph balloon dilation

  1. #1
    Join Date
    Apr 2007

    Default EGD with esoph balloon dilation

    AAPC: Back to School
    Patient in for EGD diagnostic (43235)
    Preop indications; dysphagia & history of benign esophageal stricture

    Found esophageal stricture at 37 cm and scope would not pass.
    Dilation of distal esophageal with #16.5 & #18 hydrostatic balloon.
    Then proceeds to stomach and duodenum.

    Physician has indicated 43235 & 43220

    However there is a Medicare CCI Edit of (0) in place with this code combination.

    Any suggestions on how to get her paid for both services performed?

    In other cases she used the dilator for dilation (43450) which is billable with EGD.

    Fairly new to GI billing and thankful for your help.


  2. #2


    Check 43249, I believe that is the appropriate code. I have seen some of my doctors wanting the 43235 with 43220 when they do the dilation after the EGD, but i would say 43249 especially when it is right in the middle of the EGD.


  3. #3
    Join Date
    Apr 2007



    thank you so very much for taking the time to reply
    this was so helpful
    hope you have a good day

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