Gastroenterology Coding Alert

Question: Should we automatically use the add-on code 43273 with 43260, 43261, 43263-43265 and 43267-43272?

Connecticut Subscriber

Answer: You would use 43273 (Endoscopic cannulation of papilla with direct visualization of common bile duct[s] and/or pancreatic duct[s] [List separately in addition to code[s] for primary procedure]) when your gastroenterologist views inside the ducts that carry bile to the small intestine with a second camera device (Spyglass®) inserted through the ERCP scope. Don't forget that before you can use this code, your physician will need to perform ERCP, which includes 43260, 3261, 43263-43265 and 43267-43272 (Endoscopic retrograde cholangiopancreatography [ERCP] ...).

Documentation: You should look for evidence in the physician's notes that she cannulated, entered, or penetrated the papilla of Vater, which is where the bile duct empties into the lower intestine, or that she viewed the common bile duct or pancreatic duct.