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Oct 14th, 2015 - Ruvi 5 

CPT® 43235

Medicare denies CPT® 43235 used with ICD 9- 530.89 and 553.3 stating medical necessity. However it looks like these DX codes supports medical necessity .. Please help me to figure out whether this code combination is wrong.

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Oct 14th, 2015 - rphelps 615  1 

re: CPT® 43235

Are you coding any other codes along with 43235? Is the date of service after 10-1? These codes should justify and endo getting paid.6ta3z5

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Oct 15th, 2015 - Ruvi 5 

re: CPT® 43235

This is what we billed .

05/14/2015 99223
05/15/2015 43235
05/18/2015 99238

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Oct 14th, 2015 - LBAROGIANIS 250 

re: CPT® 43235

this has some info: http://www.asge.org/uploadedFiles/Members/Practice_Management/2015%20Medicare_Physician_Payment_Presentation_Slides_FINAL_11-10-2014.pdf

What state are you from? Try looking up the LCD for CPT® 43235 on your MAC website. They usually have alot of good information.

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Oct 15th, 2015 - rphelps 615  1 

re: CPT® 43235

6ta3z5 has nothing to do with my response.

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Oct 15th, 2015 - Ruvi 5 

re: CPT® 43235

Thank you so much

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