KH1973
Contributor
Help!!! Can I bill 43249 for the dilation with 787.20, and they also did a 43239 biopsy of the stenosis with a 530.3? Do I use the mod. -59 with this one? Thanks
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Wiki 43249 and 43239
- Thread starter KH1973
- Start date
scorrado
Guest
You need a 59 on the 43239 
KH1973
Contributor
thank you, I went with the mod 59
I am curious do we always have to use code 59 with 43239....
I am curious do we always have to use code 59 with 43239 or only this case? For instance here is my situation:
CPT 43239 and CPT 45380-
"We can bill both of these CPT Codes togther as both procedures need to be done on the same day and have the insurance pay for both procedures fully.
Right now some insurances are paying only 50% for the second one and some are not paying at all.
Can you help me find out is there a modifier that needs to be used, is there another type of prior auth that needs to be obtained. What needs to be done to get paid for both CPT codes if done on the same day because it NEEDS to be done on the same.
These 2 codes are frequently billed together and we need to figure out how to get them paid."
You need a 59 on the 43239
I am curious do we always have to use code 59 with 43239 or only this case? For instance here is my situation:
CPT 43239 and CPT 45380-
"We can bill both of these CPT Codes togther as both procedures need to be done on the same day and have the insurance pay for both procedures fully.
Right now some insurances are paying only 50% for the second one and some are not paying at all.
Can you help me find out is there a modifier that needs to be used, is there another type of prior auth that needs to be obtained. What needs to be done to get paid for both CPT codes if done on the same day because it NEEDS to be done on the same.
These 2 codes are frequently billed together and we need to figure out how to get them paid."