Wiki 43239 with 43259

[catharine]

I need clarification. When these two procedures are done together and you bill them out with 43239, 43259-59 the only code that Medicare pays is 43259. Now I called Medicare and they indicate that another modifier needs to go on the 43239 and not a -59 or a -51. What is the proper way to bill for these two procedures? I'm leaning towards just not billing the EUS all together. any thoughts? Thank-you

 

[Tara0513]

I believe the issue that you are having is not just the modifier but the order. It should be 43259 43239-59 or I would use XS.

 

[GastroGal]

The modifier should be on 43239 not 43259, i would bill it as 43259 43239-XU