tci Medicare Compliance & Reimbursement - 2004 Issue 25

PHYSICIANS: Billing For Digestive Surgeries Is Causing Heartburn

Here's what physicians can and can't bill for. Physicians who are performing a lot of digestive system surgeries will need to be more careful about billing endoscopies and colonoscopies with those procedures after July 1. Thanks to CCI Version 10.2, CPT code 43201 (Esophagoscopy, rigid or flexible; diagnostic, with directed submucosal injection(s), any substance) will become a component of dozens of codes in the digestive surgery area, particularly repair (43300-43352), excision (43610-43641) and other procedures (43800-43865). Almost every code in these areas will be a comprehensive code with 43201 after July 1, but you'll be able to bill...

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