You Be the Coder: Second Dilation Yields Reduced Pay
Question: Our surgeon performed an EGD with balloon dilation, followed by a separate EGD with biopsy. Is it correct to submit the claim as 43249 and 43239-59, listing 43249 first because the RVUs are 5.23, as opposed to 5.15 for 43239?Texas SubscriberAnswer: You're correct in your code selection, but you should not report the codes with modifier 59 (Distinct procedural [...]
Want more code info & how to
articles for General Surgery Codes?
Sign-up for General Surgery Coder's FREE Trial Today to:
- Simplify general surgery codes? code lookup across CPT®, ICD-9, ICD-10, & HCPCS codes
- Get fee schedules rates, global days, MUEs all at one place
- Meet the code’s requirements with easy-to-understand tips
- Check allowed modifiers
- Cut CCI edits checking time by 94%
