Gastroenterology Coding Alert

Question: My gastroenterologist is looking into the new cholangioscopy/pancreatoscopy system, which is an endoscopic technology that allows direct visualization of the biliary system and associated ducts and organs. Which code(s) will I use to report this?

New York Subscriber

Answer: Because this is a new technology, you won't find a code at this time. However, you could report the procedure one of two ways:

(1) add modifier 22 (Increased procedural services) to a concurrent procedure code (such as, 43260, Endoscopic retrograde cholangiopancreatography [ERCP]), or

(2) report an unlisted procedure code (47999, Unlisted procedure, biliary tract) in addition to any other concurrent procedures (such as, 43269).

Benefit: Previously, gastroenterologists could only visualize the biliary system using imaging technology such as fluoroscopy or x-rays. With these new devices, which involve a tiny scope the physician can advance up the pancreatic or biliary duct, the physician can not only see the anatomy itself but directly obtain a tissue specimen of an abnormality.

Want to know more? To learn more about these devices, go to URL: www.bostonscientific.com/Device.bsci?page=HCP_Overview&navRelId=1000.1003&method=DevDetailHCP&id=10066432&pageDisclaimer=Disclaimer.ProductPage  or URL: www.olympusamerica.com/.