Wiki EGD & PEG placement

[JoannaRupert]

I need help with coding an EGD done by my GI physician on an inpatient for dysphagia while my Surgeon inserted a PEG. The hard part is that they are both sending me separate billing sheets and only the Surgeon states that he is working with the GI for his procedure. The surgeon states that after the GI performed the EGD he used the light from the EGD scope to visualize where to place the PEG.

My GI is billing for the EGD 43235 for dysphagia and the surgeon wants to bill for PEG placement. I know that 43246 is included when a single surgeon bills but can I bill both codes for both physicians, and, do I use an 80 modifier on one or both codes?

Thanks for any input.

 

[jkayser]

Hello, CPT 43246 allows modifier 62 for co-surgeons. Both physicians would bill CPT 43246-62. Here are the billing requirements and the link to this info:

http://news.aapc.com/index.php/2013...rements-for-proper-modifier-62-reimbursement/

"When submitting claims with modifier 62, each physician must document his or her own operative notes, detailing what portion of the procedure he or she performed, how much work was involved, how long the procedure took, etc. Each physician should identify the other as a co-surgeon; both surgeons should link the same diagnosis to the common procedure code; and each will submit his or her own claim."

I hope this information is helpful.

Jean Kayser CPC CIRCC