Gastroenterology Coding Alert

Prepare for a one-to-one shift on the descriptor in 2013.

For 91110 and 91111, the patient can test for esophageal reflux (530.81) and varices (456.1, Esophageal varices without bleeding). When ICD-9 transitions to ICD-10 in 2013, 456.1 will become I85.00 (Esophageal varices without bleeding).

ICD difference: Esophageal varices are extremely enlarged submucosal veins in the esophagus. They can occur with bleeding (456.0) or without bleeding (456.1). ICD-9 456.1 and its ICD-10 counterpart I85.00 carry the same descriptor verbatim, and will be used for the same function.

Coder tips: Esophageal varix is a condition that is usually associated with portal hypertension and cirrhosis. The physician may treat varices that are not bleeding with endoscopic sclerosis (43204, Esophagoscopy, rigid or flexible; diagnostic, with injection sclerosis of esophageal varices). In such cases, treatment is a prophylactic to prevent future bleeding.