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EGD with biopsy to disrupt Schatzkis ring

Robyn Posted Mon 02nd of February, 2015 14:56:01 PM

Physician performed EGD & pt was found to have a Schatzki's ring. This was "disrupted" at two points using biopsy forceps. The physician then performed balloon dilation of same stricture. Can I code for both the biopsy & dilation? I am wondering bc the biopsy was used to disrupt the stricture. Thank you.

SuperCoder Answered Mon 02nd of February, 2015 15:57:23 PM

Thanks for your question. In this case it would only be appropriate to bill 43249; Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter). The issue with billing both is that the provider is working on the same area as the dilation. If the provider used the biopsy forceps to biopsy a separate site to, for example, check for Barrett's Esophagus it would be reasonable to bill both codes.

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