# Upper endoscopy with biopsy



## lindacoder (Jun 8, 2011)

Need opinions please on how to code:

Under satisfactory topical prep with intravenous sedation, the gastroscope was advanced in the oropharyns and the patient was able to swallow the scope spontaneoulsy. The scope was advanced down the esophagus to the gastroesophageal junction. The patient had a previous laparoscopic adjustable gastric band. There was a lot of liquid in the stomach which was evacuated. A large mass was visible on the antrum of the stomach. This was nearly completely occluding the duodenum and the pylorus. At first, it was not possible to advance the scope through the pylorus because of the occlusion. However, the patient's gastric spasms relaxed gradually. Six or seven biopsies of the mass were performed in areas through the mucosa to try to get deep to the mucosa to establish a diagnosis.This was very scirrhous and hard-appearing tumor by upper endoscopy. The scope was then passed past the tumor through the pylorus. The tumor involves the pylorus itself and extends barely into the first portion of the duodenum. The first, second and third portions of the duodenum were unremarkable. The scope was withdrawn again and there was no significant bleeding from the stomach. The scope was retroflexed and several pictures of the band were taken. There was no sign of erosion or problems with the band and it did not appear to be slippe. The gastroscope was then advanced up to the esophagus and no lesions of the esophagus were noed. The patient tolerated the procedure well.

Is this just 43239???

Thanks.


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## tpontillo (Jun 8, 2011)

I would go with the 43239.


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## bdobyns (Jun 8, 2011)

43239


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## NaliniAAPC (Jun 8, 2011)

Yes 43239 only..

Nalini CPC


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