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Gastroenterology Coding Alert

You Be the Coder:

Can You Remove All Doubt About This Stent Removal?

Published on Mon Mar 23, 2009

Question: My physician gave me charges for an EGD with foreign-body removal connected to diagnosis of 936. He also performed a gastric biopsy with cold forceps for acute gastritis without obstruction. In the op note, he states that the foreign body is a plastic biliary stent that was properly positioned in the papilla and that he removed it with a snare. He wants me to use 43247 for the procedure. My dispute is that he went into the papilla to remove the stent, which I think 43269 better describes. If he had removed the stent from the stomach or any other area I would agree with 43247. What codes are appropriate for this case? Utah Subscriber Answer: Just code for the EGD with biopsy (43239,Upper gastrointestinal endoscopy including esophagus,stomach, and either the duodenum and/or jejunum a appropriate; with biopsy, single or multiple). To bill ERCP with removal (43269, Endoscopic retrograde cholangiopancreatography [...]
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