Gastroenterology Coding Alert
Be Aware of the Cause of Bleeding When Reporting EGDs
Question: The medical record states that the gastroenterologist performed an esophagogastroduodenoscopy (EGD) and placed three hemoclips to control bleeding. Do I report the bleeding control separately? Ohio Subscriber Answer: The answer to this depends on whether the surgeon caused the bleeding. If the bleeding was not a result of the biopsy, you may report procedure codes such as 43239 (Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple) for the biopsy and 43255 (Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method) for control of bleeding. You’ll also need to add modifier 59 (Distinct procedural service) to 43255 in this scenario. If the surgeon caused the bleeding during the procedure itself, you should only report 43239. This is because addressing the bleeding is part of the procedure if the procedure itself caused it.
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