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Panendoscopy with Botox Injection

Carol Posted Tue 05th of February, 2013 15:40:17 PM

Is it correct to code the Endoscopy first and the botox injection with a modifier 59? I do not see where the two are bundled anywhere or is there a more correct way to code for this procedure.

SuperCoder Answered Wed 06th of February, 2013 17:26:12 PM

You can report the Botox supply, but not the injection, separately from the EGD.

On the claim:

report 43236 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed submucosal injection[s], any substance) for the EGD with injection. (Code 43236 includes the act of injecting, so do not report any other CPT code for injections.)

report J0585 (Botulinum toxin type A, per unit) for the supply of Botox (the drug supply is not bundled into 43236).

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