Gastroenterology Coding Alert

Question: Our doctor did a follow-up endoscopy to treat reoccurring varices. Upon examination, the patient has no obvious varices and no other symptoms, but does have hepatitis C with cirrhosis. An EGD with banding of varices was performed several months ago. What is the appropriate diagnosis code for this endoscopy? Should I use V67.59 (follow-up examination) because there were no symptoms? Or should I use 456.1 (esophageal varices without mention of bleeding) because the doctor wasnt sure whether varices were healed?

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Answer: You should use 456.1 because the patient is still being treated for the varices. Most payers do not reimburse V codes, and you probably will not receive payment if the follow-up code is used as a diagnosis.

 
Reader Questions and You Be the Coder answered by Linda Parks, MA, CPC, lead coder at Atlanta Gastroenterology Associates, a 23-physician practice.