Robyn Posted Tue 20th of January, 2015 15:52:06 PM
Physician performed an EGD to stomach atrum & did a Botox injection in the esophagus. I was going to bill 43236 for the EGD/injection & J0585 for the Botox, but I was wondering if I needed a 52 modifier on 43236 since he stopped before scoping the duodenum?
SuperCoder Answered Tue 20th of January, 2015 16:39:15 PM
Thanks for your question. You are correct. To report esophagogastroscopy where the duodenum is deliberately not examined (eg, judged clinically not pertinent), or because the clinical situation precludes such exam (eg, significant gastric retention precludes safe exam of duodenum), append modifier 52 if repeat examination is not planned, or modifier 53 if repeat examination is planned. Hope this helps.