Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Gi EGD with Biopsy and balloon dilation

Thomas Posted Wed 28th of October, 2015 11:39:26 AM

Saw the answer to previous question and understand no modifier to be used when billing following CPT codes. When Medicare processes claims with codes:
they show CPT codes listed with modifiers as 43249
43239 59 51
Confused as to use modifers or leave off?

SuperCoder Answered Thu 29th of October, 2015 07:07:30 AM

CMS CCI edits do not show any bundling or modifier requirement in between these codes. Still, you can append modifier -51 with CPT 43239 to indicate the multiple procedure as the RVU value of CPT 43239 is lesser than CPT 43249.

Related Topics