Wiki 2014 Changes - 43248

plynn

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Clarification Please

Procedure: Esophagogastroduodenoscopy and esophageal dilation

Findings: The tubular esophagus was tortuous. There was a Schatzki ring noted at the gastroesophageal junction. This was dilated with a 54-French Savary dilator over a guide wire. Biopsies were also obtained in the esophagus to rule out eosinophilic esophagitis as the cause of dysphagia. There was a large hiatal hernia noted almost the length of about 8 cm. The diaphragmatic hiatus was at 39 cm, and the squamocolumnar junction was at 31 cm. There was minimal heme noted in the stomach, and there were erosions also noted in the antrum. Biopsies were obtained in the antrum, incisura and the body to rule out H. pylori infection. The duodenal bulb appeared normal. The mucosa in the second part of the duodenum appeared to be slightly flat. Biopsies were obtained to rule out celiac disease. The patient tolerated the procedure well. No complications.

2013 would code as 43248 & 43239
However with the 2014 verbiage change on 43248 not sure this is correct.

Any feedback with rationale would be greatly appreciated
 
I think 43248 with 43239 is still the correct coding. The verbiage change in the 43248 code description is pretty cosmetic. The crucial difference is there are notes explicitly stating you can't bill 43248 with a stent placement (43266) or an ablation (43270), but 43239 is not forbidden.
 
That is what I thought ....
Thank you so much for taking the time to review and reply!!!
 
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