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EGD's with modifiers

Thomas Posted Tue 30th of June, 2015 21:27:10 PM

What is the correct order of coding for EGD with baloon dilation of esophagus (43249) AND EGD with Biopsies at same setting?
We coded 43249 first and 43239-59 second and Medicare allowed
$158.78 for 43249 AND $15.84 for 43239-59.

SuperCoder Answered Wed 01st of July, 2015 00:52:05 AM

No Need to bill CPT code 43239 with 59 modifier. CPT code 43249 and 43239 can be billed together without any modifier.

Also, RVU value of 43249 is $113.70 and of 43239 is $101.90. So the correct order to bill is
1. CPT 43249
2. CPT 43239

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