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Gastroenterology Coding Alert

Reader Question:

Place Your Focus on Bleeding Control When Different Techniques Are Used

Published on Tue Feb 14, 2012

Question: Our gastroenterologist performed an EGD. During the procedure, a lot of bleeding occurred from a pinpoint hole in the gastric mucosa; the physician attempted to control the bleeding by injecting 1ml epinephrine (1:10,000) into the area. However, the bleeding continued. So, our gastroenterologist then tried to cauterize the area to arrest the bleeding and was successful. Now our gastroenterologist is of the contention that the procedures should be billed using 43236, 43255 and 43258. Is this correct?Michigan SubscriberAnswer: From your description, it is very clear that your gastroenterologist mainly attempted to control the bleeding using two different procedures. These different procedures were performed on the same site with the intention of bleeding control only.So, in this scenario, you will only need to report the EGD code that covers control of bleeding. Therefore, you will only need to report this procedure with 43255 (Upper gastrointestinal endoscopy including esophagus, stomach, and [...]
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