# Ileoscopy via stoma with biopsy and control of bleeding



## storves (Feb 10, 2010)

I have an encounter in which the provider did an Ileoscopy via the stoma and did biopsy(s) 44382, however they also placed clips and use cautry to conrol bleeding. I do not see a code for the bleeding control via stoma. Should I use an unlisted or 44378 ileoscopy(not through stoma) with control of bleeding?


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## elenax (Feb 11, 2010)

Was the bleeding caused by the gastroenterologist during the procedure?...then you cannot bill it separately...

I got this information from the Coding Institute Vol. 10 2008:

"Gastroenterologists may use many of the same techniques for cauterization (to control bleeding) and for ablation...and the code definition can also be confusing...but the defining factor is the clinical situation and diagnosis, Weinstein says.
For example use control of bleeding when:
. controls bleeding from a polypectomy site *several days after* the initial polyp removal
. is treating diverticulitis with *hemorrhage*
. is treating angiodysplasia with *hemorrhage *
. If the gastroenterologist caused the bleeding...even though...had to use cautery to control bleeding...it is included in the surgical package..."

hope this helps


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## coachlang3 (Feb 11, 2010)

As neonelena stated, if the doctor was controlling bleeding from the biopsy just performed, you cannot bill for that as it's an inherent part of the procedure.

However, if it was a seperate incident, I would think you would do the 44378.


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