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Endoscopy Coding

Lina Posted Mon 01st of December, 2014 10:54:55 AM

Hi my question is regarding these 2 codes:
43247 And 43235?
It was billed 43247 59
Insurance paid for 43247 and denied 43235 stating that the service is included in the payment for another service/procedure
Can you please tell me what was done wrong and help me how to fix this

Thank you

SuperCoder Answered Mon 01st of December, 2014 11:02:48 AM

As per CCI edit, code 43235 is a coloumn 2 code for 43247 and these codes cannot be billed together in any circumstances.Hence, you could only bill code 43247.

Thanks !!

SuperCoder Answered Mon 01st of December, 2014 11:20:43 AM

Thanks for your question. The denial that you received is correct. 43235; Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) is bundled into 43247; Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body. You cannot bill both of these codes together under any circumstance as 43235 is the base diagnostic procedure to 43247.

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