tci Part B Insider - 2006 Issue 8

GASTROENTEROLOGY: Reader Question--Two Codes Are Better Than One For Control Of Bleeding

Question: I received a claim that shows the gastroenterologist injected epinephrine into a duodenal ulcer to control active bleeding during endoscopy with biopsy (43239, ...with biopsy, single or multiple). Should I report 43239-22 for this procedure?Colorado Subscriber Answer: Instead of reporting 43239-22 and struggling to provide all the additional documentation that the payor will require for a modifier 22 claim, you can accurately describe this session by reporting 43239 for the biopsy and 43255 for the control of bleeding, says Michael Weinstein, MD, a gastroenterologist in Washington, DC, and a former member of the CPT advisory panel. Code...

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