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Wiki EGD with esoph balloon dilation

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plynn

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Patient in for EGD diagnostic (43235)
Preop indications; dysphagia & history of benign esophageal stricture

Found esophageal stricture at 37 cm and scope would not pass.
Dilation of distal esophageal with #16.5 & #18 hydrostatic balloon.
Then proceeds to stomach and duodenum.

Physician has indicated 43235 & 43220

However there is a Medicare CCI Edit of (0) in place with this code combination.

Any suggestions on how to get her paid for both services performed?

In other cases she used the dilator for dilation (43450) which is billable with EGD.

Fairly new to GI billing and thankful for your help.

pvaughn
 
Check 43249, I believe that is the appropriate code. I have seen some of my doctors wanting the 43235 with 43220 when they do the dilation after the EGD, but i would say 43249 especially when it is right in the middle of the EGD.

Bob
 
Bob,

thank you so very much for taking the time to reply
this was so helpful
hope you have a good day
plynn
 
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