ssmith955
Contributor
Our provider delivered Pillcam with EGD scope but he also took biopsies from esophagus. I billed 91110/26 and 43239, this was done as outpt procedure
in hospital. BCBS Fl has denied 43239 stating it is bundled with 91110/26. I know that somewhere I have read that if biopsies are taken that the 43239 is
a separate procedure and is billable and is not bundled. I need to write an appeal letter but can't find and specific guidelines stating that fact. Can any one one
direct me to a source that would clarify that is bx taken the 43239 is payable. I need to make copies so that I can attached to the appeal letter.
We have Super Coder, can find nothing there and I have also looked on AAPC coding forum. Please help me because the insurance can't get away
with bundling and not paying the 43239. Thanks you
in hospital. BCBS Fl has denied 43239 stating it is bundled with 91110/26. I know that somewhere I have read that if biopsies are taken that the 43239 is
a separate procedure and is billable and is not bundled. I need to write an appeal letter but can't find and specific guidelines stating that fact. Can any one one
direct me to a source that would clarify that is bx taken the 43239 is payable. I need to make copies so that I can attached to the appeal letter.
We have Super Coder, can find nothing there and I have also looked on AAPC coding forum. Please help me because the insurance can't get away
with bundling and not paying the 43239. Thanks you