CPT 2002 Revises Control-of-Bleeding, Adds Emerging-Tech Codes
Published on Sat Dec 01, 2001
Revisions to the control-of-bleeding and dilation codes are among the significant changes of interest to gastroenterologists in CPT 2002. While most of the gastroenterology changes are fairly minor, they are part of a move toward compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and a gradual transition to CPT-5, the next generation of current procedural terminology.
"There aren't as many code changes for gastroenterology as there were last year, and many of the changes in the digestive section of CPT 2002 are surgical codes," says Joel Brill, MD, a gastroenterologist in Phoenix and the American Gastroenterology Association's representative for the CPT editorial advisory committee. "Many of the endoscopy revisions are part of the transition from CPT-4 to -5 and to HIPPA, where more granularity and more preciseness in coding descriptions are called for."
Control-of-Bleeding, Dilation Codes More Specific
One of the main revisions to the endoscopy codes was the wording of the control-of-bleeding descriptions. The following control-of-bleeding codes have been revised: Note: Changes are in bold.
43227 esophagoscopy, rigid or flexible; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44366 small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44378 small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44391 colonoscopy through stoma; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
45334 sigmoidoscopy, flexible; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
45382 colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
46614 anoscopy; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator).
The phrase "any method" has been deleted from all of these definitions and has been replaced with a list of specific control-of-bleeding methods. This is mainly a stylistic change, and the codes still refer to all methods, Brill says. While the description list contains all the methods now used to control bleeding, any new methods would be covered by these codes as well.
Note: The only control-of-bleeding code that was not revised was 43255 (upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method). This is a technical error, Brill says, which shouldn't make any difference to payers or providers.
Though injections are now specifically mentioned in the revised definition, sclerotherapy injections to control bleeding should still be reported with [...]
