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EGD and AVM
Published on Sun Oct 01, 2000
Question: How should we report an esophagogastroduodenoscopy (EGD) and the cauterization of gastric arteriovenous malformations (AVMs) done with an ERBE?
Linda Dries
Hackensack, N.J.
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Answer: An ERBE (named for ERBE Elektromedizin GmbH, the company that produces the product) uses argon-plasma coagulation to cauterize tissue, according to Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and a member of the American Medical Associations CPT advisory panel. It is one of several cautery devices that a gastroenterologist may use to control gastrointestinal bleeding and generally is not used to remove tissue.
If the gastric AVM was actively bleeding when found by the gastroenterologist and then cauterized with the ERBE, 43255 (upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate with control of bleeding, any method) should be used to report the procedure, says Weinstein.
If the AVM was not bleeding but was destroyed by the gastroenterologist with the ERBE, 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) should be used.
