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Gastroenterology Coding Alert

Reader Question:

Clarify Appropriate Use of Modifiers

Published on Tue Jun 12, 2012

Question: Our gastroenterologist recently attempted a colonoscopy through the stoma after removal of the ostomy bag. The procedure notes read like this:After removing ostomy bag, I attempted to insert my pinky finger into the ostomy site and immediately, there was some bright red blood. I attempted to use the endoscope to advance into the ostomy and met with resistance. Multiple attempts were made with the scope to advance slightly, but due to resistance, I could not advance the scope to any meaningful degree. Given the active bleeding from this site after just finger insertion and attempt at endoscope insertion, I injected 2mL of epinephrine. His heart rate increased appropriately and as expected, however, he did start complaining of back pain. Due to my inability to advance the scope due to narrowing and also the patient's complain of back pain, the procedure was stopped.How do I report this procedure and should [...]
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