Medical Billing Coding - Is 43259 billable under POS Office, cpt, codes
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Thread Topic: Is 43259 billable under POS Office
Topic Originator: Deepak Jadhav
Post Date March 25, 2008 @ 7:28 AM
Is 43259 billable under POS Office

Deepak Jadhav
March 25, 2008 @ 7:28 AM Reply  |  Email Friend   |  |Print  |  Top

Is procedure code 43259 - Upper GI endoscopy with endoscopic ultrasoundexamination billable with Place Of Service. We have been billing this code for a certain GI practice in New York and GHI and HIP insurance deny the claim as place of service inappropriate. Is it justified...

March 25, 2008 @ 11:54 AM Reply  |  Email Friend   |  |Print  |  Top

It's possible.  You shoudl ask for a copy of the carrier's policy on this procedure before you start appealing.

August 20, 2008 @ 11:36 AM Reply  |  Email Friend   |  |Print  |  Top

Hi All,
We also face the same problem. GHI and HIP both deny these services stating that place of services is inappropriate. When request for the guideline they say they follow the CMS guideline however Medicare are issuing payment for this code at place of service office (11).

It would be great if anyone could help to get this issue resolved.

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