CPT^® 43249, Under Esophagogastroduodenoscopy Procedures

The Current Procedural Terminology (CPT^®) code 43249 as maintained by American Medical Association, is a medical procedural code under the range - Esophagogastroduodenoscopy Procedures.

Additional/Related Information

Tabs

Summary

The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 43249 ? Start a discussion here

Billing Mod 59 and 51 on the same line

Is it ever appropriate to append both modifier 59 and 51 to the same line item? and if so, is there a particular order in which they should be billed? For Example, I have the following codes billed ... [ Read More ]

Bill both 43248 & 43249?

This data is very dated. Can anyone offer advise on billing the 43248 and 43249 together in the same session. The first approach did not show any abnormality so it was decided to proceed dilation of t... [ Read More ]

EGD Bundling

EGD with esophageal balloon dilation and biopsy. There is a [B]CPT[/B] assistant that states [B]43239 and 43249 can[/B] be coded [B]together[/B] with a modifier on the same day, but [B]can[/B] both be... [ Read More ]

Denials with 59 modifier

We are receiving a lot of denials from different insurance companies when 59 modifier is added to another EGD or Colonoscopy CPT code. Per the guidelines, modifier 59 can be added if a biopsy is obta... [ Read More ]

CPT 43249 and 43239

I would used modifier 59 too. Check you payment. Is the payment for 43249 higher than usual. Your payment for the second procedure could be wrapped all it one.... [ Read More ]

CPT 43249 and 43239

There is an edit between these two codes. The XS modifier can be used to override the edit for procedures where separate lesions are involved. I think because CPT 43249 is not a procedure performed on... [ Read More ]

CPT 43249 and 43239

Can someone tell me why I am not getting paid for both 43249 and 43239-XS with Blue Cross Medicare Advantage plans? 43249 was billed with DX code K22.2 and 43239-XS was billed with K31.89 and R13.19.... [ Read More ]

43249 and 43239

you need to look at the payer and their coding edits. Blue Cross does not allow you to bill 43249 with 43239 but other insurances do.... [ Read More ]

43249 and 43239

can 43249 and 43239 be reported separately with a modifier or are they bundled?... [ Read More ]

Dilations and Biopsies during EGD

[b]43239 and 43249[/b] I have a related question. If an EGD with balloon dilation (ie. 43249) is performed on an esophageal stricture and biopies of the esophagus are taken to evaluate for eosinophil... [ Read More ]

View All