Wiki Question on billing multiple procedures-I just want to verify

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sbarrila

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I just want to verify that you can bill a 43259 and a 43239 with a 59 modifier. Also a 43242 and a 43239 with 59 modifier. Pretty sure that you can but just want to double check. Thanks!!!!!
 
EUS + EGD W/bx

The answer is yes they can. However, our practice has also had problems with this. Many of the Commercial carriers have updated the claims processing software, and let's face it none of these software packages are perfect. According to the NCCI edits, both code pairs are billable together. If you are running into problems with the commercial carriers I have had good success with appeal letters including a cut and paste copy from the current NCCI edits showing that the code pair is billable together. The NCCI edits can be found on the CMS website.
 
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