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Double Balloon Endoscopy

  1. Default Double Balloon Endoscopy
    Medical Coding Books
    I have a physician performing a double balloon endoscopy. The only code I can find is 43249 which is a single balloon endscopy. The double balloon is much more extensive so we have been billing this procedure with the unlisted code and we are having trouble getting paid. Is there anyone that can help with a better way to code/bill this? Thank you for any guidance that can be provided.

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    Quote Originally Posted by BarbieZ View Post
    I have a physician performing a double balloon endoscopy. The only code I can find is 43249 which is a single balloon endscopy. The double balloon is much more extensive so we have been billing this procedure with the unlisted code and we are having trouble getting paid. Is there anyone that can help with a better way to code/bill this? Thank you for any guidance that can be provided.
    It appears this procedure has not yet been assigned a CPT code. Your choices are to use the unlisted code as you have been, or to use the 43249 with a 22 modifier. Either way you will have to continue to send documentation for this procedure until the AMA adds a CPT code for it.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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