Gastroenterology Coding Alert
Don't Forget to Report Sphincterotomy Separately Along With Dilation
Question: Our gastroenterologist recently performed an ERCP procedure during which he extended an existing sphincterotomy. What CPT® code should I use to report the procedure that my gastroenterologist performed? Also, if he dilates an existing sphincterotomy, what code should I use?
New Jersey Subscriber
Answer: When your gastroenterologist performs an ERCP procedure along with sphincterotomy, you will have to report the procedure with 43262 (Endoscopic retrograde cholangiopancreatography [ERCP]; with sphincterotomy/papillotomy). You will have to report the same CPT® code when your gastroenterologist performs the ERCP and extends the existing sphincterotomy.
In case of dilation of the existing sphincterotomy, you will have to report the procedure your gastroenterologist performed using 43271 (Endoscopic retrograde cholangiopancreatography [ERCP]; with endoscopic retrograde balloon dilation of ampulla, biliary and/or pancreatic duct[s]). Since this procedure was performed on an existing sphincterotomy, you will also have to report 43262 along with 43271.
Gastroenterology Coding Alert
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