Gastroenterology Coding Alert
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Question: The patient was positioned appropriately for an upper endoscopy. A bite block was placed and Olympus videoscope introduced into the oropharynx and, under direct visualization, the esophagus was intubated. There was evidence for four columns of 2-3+ distal esophageal varices, which were bluish and tortuous. Stomach examination revealed 1 Dieulafoy ulcer in the fundus measuring about 0.5 cm. Endoclip was applied locally to this ulcer to achieve hemostasis, although this Dieulafoy lesion was not bleeding at the time of endoscopy. Upper small bowel was within normal limits without any ulcers or mucosal lesions. The scope was then withdrawn and loaded with banding device, and four bands were successfully deployed to distal esophageal varices without any complications. Pennsylvania Subscriber Answer: For procedure codes, you should use 43244 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with band ligation of esophageal and/or gastric varices) and 43258 (Upper gastrointestinal endoscopy including esophagus,stomach, and either the duodenum and/or jejunum as appropriate; with ablation of tumor[s], polyp[s], or other lesion[s] not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique). You do not need to append modifier 59 (Distinct procedural service) to 43258 because that code is not normally bundled into 43244.
Gastroenterology Coding Alert
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Compare Your EGD Coding to Our Expert
Question: What procedure codes would you use for this patient encounter? The patient was positioned [...] - READER QUESTIONS:
Symptom Code Matches Stomach Description
Question: What is the diagnosis code for antral erythema? Ohio Subscriber Answer: If your gastroenterologist [...] - READER QUESTIONS:
Zero Means Never When It Comes to CCI Bundles
Question: Our colorectal surgeons periodically perform an anoscopy (46600) and a proctosigmoidoscopy (45300). CCI edits [...] - READER QUESTIONS:
What to Do When Doctor Says 1 Thing,Notes Say Another
Question: How would you code this office visit? Another office refers a 49-year-old patient to [...] - READER QUESTIONS:
Endo Loop Suggests Snare Technique for Polyp
Question: What code describes this procedure? A single 20 mm pedunculated polyp with no stigmata [...] - READER QUESTIONS:
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Term Indicates Severity of Patient's Esophagus Problem
Question: How should I code the diagnosis "Barrett's with high-grade dysplasia?" Alaska Subscriber Answer: The [...]
