Wiki 43239 denied with other EGD codes

[lrosselli]

For Pennsylvania coding, all of a sudden 43239 (EGD/BX) is getting denied when billed with other EGD codes such as 43270 or 43248. Neither of these combos are on the NCCI Edits. The insurances are saying 43239 has an incidental relationship with the other billed procedure codes. The only way to bypass the denial is to add modifier 59 to 43239. Has anyone else had this problem recently?

 

[ibtrazy2u]

We are in VA and are also having this issue. Would love some feedback. Thanks.

 

[afalcon@dhcla.com]

In Louisiana we have to code 43239 with the -59 modifier. We been doing this for about 5-7 years now.