# Schazky's Ring to code or not to code?



## ruthan (Jun 4, 2014)

My co-worker and myself are questioning if we should even consider coding Schatzky's Ring when it is documented in our EGD operative report.  And if we do pick it up should we really be Physician Querying all the time to figure out if this is a "acquired or congenital" condition.

We have read the CC1Q2012 Page. 15 - 16, and are still unsure.  For example we have a study in which the patient came in for Dysphagia, during the EGD they took biopsy of some gastric erosions and the Physician also said even though patient had no masses or strictures, there was a Schatzki's Ring present at the GE junction.  Later in the EGD report is stated they did a dilation using a Savary dilating guidewire.

So we are questioning first of all because the patient came in with Dysphagia (and according to what we read schatzki ring is a sign of Dysphagia) should we even be picking this diagnosis up....

Also questioning on the coding of the Congenital or Acquired portion.  In our facility I have never seen our Gastro. Doctor's documented if it is acquired or congenital.  And upon my reading it says if it is a new significant finding then code as acquired.  But if we don't know if this is truly a initial finding of this....should we be sending the Phys. a query on all of these??


----------



## jbrightw (Jun 14, 2014)

Long-term gastroesophageal reflux disease causes chronic inflammation and thus chronic damage to the lower esophagus which may result in Schatzki's Ring. Hence if it is not mentioned as congenital in older patients, use 530.3 (Stricture/stenosis of esophagus) as acquied which makes sense. No need to code dysphagia as it is a symptom of 530.3.

Jesus Brightwin


----------



## afuller (Dec 25, 2014)

"In the case of a newly diagnosed Schatzky’s ring in an adult patient, without additional documentation of whether the condition is congenital or acquired, query the physician for clarification. If the physician determines that the condition is acquired, assign code 530.3, Stricture and stenosis of esophagus. If the physician cannot determine whether the condition is congenital or acquired, the default in ICD-9-CM is congenital. However, Schatzky’s ring would be a reportable condition only if it meets the definition of a secondary diagnosis, in that it must be clinically significant or symptomatic. In most cases, when a Schatzky’s ring is found, it is an incidental finding."


----------



## syllingk (Jan 5, 2015)

It doesn't sound incidental to me as you state the doctor did a dialation of the esophagus for it. That would lead me to the correct procedure code to go with it, not just an EGD but an EGD with dilatation of esophagus either transendoscopic or over a guide wire.


----------

