# 43453 Clarification



## plynn (Aug 2, 2012)

Help Please...

documentation clearly states dilation over guidewire (43453)
however there is nothing regarding fluoroscopy being used
i know that fluroscopy is listed in the description of procedure - was unsure if that was necessary to bill.

Procedure Note;
Findings: Esophagus: the proximal and middle part of esophagus was normal. there was a stricture noted in the distal esophagus at the gastroesophageal junction. this appeared to be a peptic stricture. this was dilated over a guide wire at 51 french and 54 french savary dilators. the stomach appeared normal. the duodenum appeared to be normal.

I was going to bill 43235 & 43453 (?)

Please provide thoughts / suggestions


----------



## cingram (Aug 2, 2012)

If you bill both of those dont forget your modifier.


----------



## plynn (Aug 3, 2012)

cingram - 

i am asking for suggestion regarding "if" the codes I have listed are the best / appropriate billing option.

as I stated I am unsure about the fluro on 43453 description 

can you please comment on that 

i really do apprecriate any help you or anyone else can give


----------



## bdobyns (Aug 3, 2012)

was the intent of the procedure just for the dilation of the esophagus or was the procedure as an EGD?  If it was an EGD then you should take a look at code 43248


----------



## coachlang3 (Aug 3, 2012)

bdobyns said:


> was the intent of the procedure just for the dilation of the esophagus or was the procedure as an EGD?  If it was an EGD then you should take a look at code 43248



Agree, totally.


----------



## MoonSad137 (Aug 3, 2012)

bdobyns said:


> was the intent of the procedure just for the dilation of the esophagus or was the procedure as an EGD?  If it was an EGD then you should take a look at code 43248



This is how I'd code this situation.


----------



## johnstond (Aug 5, 2012)

*Debbie J*



plynn said:


> Help Please...
> 
> documentation clearly states dilation over guidewire (43453)
> however there is nothing regarding fluoroscopy being used
> ...



From the limited procedure description indicating "stomach and duodenum appear normal", this appears to be an "EGD with dilation over a quidewire", although there no description about the insertion of the scope. S0.................CPT 43248 would be my suggestions.


----------



## plynn (Aug 6, 2012)

Thank you all so very much .... yes, it was EGD and 43248 looks great!!!


----------

