# Upper GI What CPT would you use??



## carsosa (Sep 13, 2013)

This is from actual report:
The Endoscope 2510190 was introduced through the mouth, and under direct visualization advanced to the duodenal bulb. A careful inspection was made as the endoscope was withdrawn. The upper GI endoscopy was performed with difficulty due to stenosis. The paient tolerated the procedure fairly well.

Findings:
Thickened and fibrotic-appearing epiglottis. Unable to pass the GIF-160 endoscope. A guide wire was placed under fluoroscopic guidance, then the scope was withdrawn. Using the wire as a guide, dilation with a 10-11-12 mm balloon (to a maximum balloon size of 12 mm) dilator was performed under fluoroscopic guidance. The GIF-160 endoscope still could not be passed into the esophagus, but the XP-160 scope passed with mild resistance. A Savory guide wire was placed under the endoscopic guidance and the scope was withdrawn. A 39 FR Savary dilator was passed over the guide wire with moderate resistance. This was successfully dilated. No gross lesions were noted in the entire esophagus. The entire examined stomach was normal. The duodenal bulb was normal.


----------



## lekishabryant@rocketmail.com (Sep 13, 2013)

*Upper GI*

I would be looking at 43235.


----------



## carsosa (Sep 13, 2013)

I was told to use 43235, 74360, and 44799.
Ugg, this is frustrating


----------



## BABS37 (Sep 13, 2013)

You have to bill 43220 or 43226 in order to bill for the S&I code 74360... and I don't think either of those codes support the documentation as the physician uses an endoscope. I would look closer at 43248 or 43249...just my opinion...


----------



## hbeard (Sep 13, 2013)

Because the provider did get past the pylorus, the EGD codes would apply. I would consider 43248 and 43249-59 (since he had to do both guidewire dilation and balloon dilation)and the 74360.


----------

