Gastroenterology Coding Alert

Question: Our gastroenterologist treats a patient who has a gastrostomy tube. The op note indicates that the patient has "some issues with granulation tissue at the stomal site that gets irritated and bleeds." The physician performed "argon plasma photoablation of granulation tissue at stomal site." Can I use 17110 even though its descriptor says nothing about plasma ablation?

Oklahoma Subscriber

Answer: Yes. You should use 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) for the procedure. Link that to a diagnosis of 701.5 (Other abnormal granulation tissue).

Although 17110 doesn't specifically mention plasma ablation, the wording doesn't rule it out, either. Gastroenterologists usually use argon plasma coagulation -- jet of ionized gas -- to treat bleeding inside the body.