My physicians will very seldom require to use an alternate method of dilation when one doesn’t produce the result they desire. For example, they will perform a 43248(guide wire) and a 43249(balloon) in the same session. Most recently, we billed those two codes along with a 43239(biopsy) and received a denial only for the biopsy. Both dilations were allowed and paid. Is anyone aware of a new CCI edit or otherwise restricting these code parings? If we were to bill only one dilation with the biopsy we would be paid substantially more then the payments received for both dilations which makes no sense. Thoughts appreciated.
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Anal dilations after PSARP
Good morning,
I wonder if we can charge for the anal dilations in the office after pt has PSARP done? Is it part of the surgical global period? If yes, do you charge the E&M level with 24 modifier? For example 99213-24 or do you use 45905 with 52 modifier since this was not done under the anesthesia. Thank you for any inputs!
Angie