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Gastroenterology Coding Alert

Reader Query:

Pay Heed to Payer Inputs for Smooth Payouts

Question: A patient had an EGD with injection and the provider used bicap cautery to endoscopically control bleeding from AVMs and performed biopsy on suspected masses. I billed Medicare 43255 first CPT® code and 43239-59 second CPT® code, however, Medicare added modifier 59 to 43255 and 59 plus 51 to second CPT® 43239. What should I do? Oklahoma Subscriber  Answer: If you [...]