I would Code:
43239-59 (Even though the biopsy was done in two separate location it was done only with one method "cold forceps" and this codes allow "single" and "multiple" biopsies)
The following information I got from the "Gastroenterology Coding Alert VOL. 10 2008:
"The modifiers you attach on this claim will depend on your payer. Many coders would likely have to attach modifier 59 to 43239. But some commercial payers in some state, you may have to attach modifier 59 and modifier 51 to get this combinantion paid. Always verify with the CCI. Some payers will want you to use a combo of modifiers"
You said you already got denied, CCI does not bundle 43248 and 43239; I would appeal it with copy of the report and copy of the CCI.
Hope this helps,
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join