Gastroenterology Coding Alert

Reader Question:

File 1 Code for EGD With Stent

Question: What code should I use for an upper gastrointestinal endoscopy (EGD) with a mesh stent placement? Are there any other services I can bill for in addition to the endoscopy?

Kansas Subscriber

Answer: When a gastroenterologist places any kind of stent during an EGD, report 43256 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic stent placement [includes predilation]).

If the physician only performed the EGD with stent placement, you cannot bill for any other services - predilation, which some may view as separately billable, is bundled into 43256.

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