You Can Report Multiple Endoscopies
Published on Sun May 18, 2008
If the surgeon performs another endoscopic procedure (for instance, 43239, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple) during the same session as PEG tube placement (43246), you can bill for both procedures separately. Keep in mind that the multiple-endoscopy rule will apply. The payer will reimburse only the higher-valued procedure at 100 percent of the fee schedule amount. For the lesser-valued procedure, you will receive the standard fee schedule amount minus the value of the "base" endoscopic procedure -- in this case, 43235 (- diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]).