Gastroenterology Coding Alert

Question: During endoscopic retrograde cholangiopancreatography (ERCP), the GI extracted four stones from the patient's pancreatic duct using the basket technique. What is the proper code to describe this?


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Answer: The -basket technique- describes a procedure in which the physician places a catheter with a basket over a guide wire into the pancreatic ducts. The basket scoops up the stone, which is then withdrawn into the duodenum and let loose.

You should claim 43264 (Endoscopic retrograde cholangiopancreatography [ERCP]; with endoscopic retrograde removal of calculus/calculi from biliary and/or pancreatic ducts) for all stone removals using the basket technique in the bile or pancreatic ducts.
 
You must report a single unit of 43264, regardless of the number of stones the physician extracts.

In addition, 43264 is the correct choice if the physician uses a balloon to remove the stones rather than using a basket.

Warning: Some coders mistakenly report 43271 (Endoscopic retrograde cholangiopancreatography [ERCP]; with endoscopic retrograde balloon dilation of ampulla, biliary and/or pancreatic duct[s]) in addition to 43264, but you should not use 43271 because there is no ductal dilation when the physician removes stones, even if he uses a balloon during the procedure.