# EGD w/BX and Pillcam Placement



## ssmith955 (Sep 1, 2017)

Our provider delivered Pillcam with EGD scope but he also took biopsies from esophagus. I billed 91110/26 and 43239, this was done as outpt procedure
in hospital. BCBS Fl has denied 43239 stating it is bundled with 91110/26. I know that somewhere I have read that if biopsies are taken that the 43239 is 
a separate procedure and is billable and is not bundled. I need to write an appeal letter but can't find and specific guidelines stating that  fact. Can any one one
direct me to a source that would clarify that is bx taken the 43239 is payable. I need to make copies so that I can attached to the appeal letter.
We have Super Coder, can find nothing there and I have also looked on AAPC coding forum.  Please help me because the insurance can't get away
with bundling and not paying the 43239.   Thanks you


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## sequester25@gmail.com (Sep 1, 2017)

http://mcgs.bcbsfl.com/?doc=Wireless Capsule Endoscopy

Seems to me like they do not state that 43239 bundles just that you need pre-authorization for medical necessity. I would call and ask for the documentation that states it bundles. Could be a stall tactic.


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