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Gastroenterology Coding Alert

Reader Questions:

Dilatation, Stent Placement Cannot be Reported Separately

Published on Sat Jan 01, 2005

Question: A patient presented for a stent placement, which the gastro inserted while performing a flexible sigmoidoscopy with balloon dilatation of the colonic stricture. What is the best way to report these procedures?

Wisconsin Subscriber

Answer: Report only the stent placement, because CPT bundles the balloon dilatation into the stent placement code. On the claim, you should:
   report 45345 (Sigmoidoscopy, flexible; with transendoscopic stent placement [includes predilation]) for the stent placement.
 
Do not report 45340 ( ...with dilation by balloon, 1 or more strictures) for the balloon dilatation, because the dilatation is bundled into 45345.
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