Gastroenterology Coding Alert
Reader Questions:
Find Diagnosis in Chart, Not LCD
Published on Tue Jul 20, 2021
Question: Which diagnosis code is payable for an upper GI on a 12-year-old patient? California Subscriber Answer: You should look at the medical record and select the appropriate diagnosis code based on what the physician documented as the reason for and/or findings of the upper GI so you can select the right diagnosis code. You should never base your ICD-10-CM code on what you think the insurer will pay. Always code from the medical records and not from the local coverage determination (LCD). In general, upper GI endoscopy in children is performed for the same diagnoses as in adults.
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