Gastroenterology Coding Alert

Question: Our doctor performed an EGD using argon plasma coagulation of duodenal angiodysplasia. There was no active bleeding; he just treated arteriovenous malformations. How do I code this?

Missouri Subscriber

Answer: For the diagnosis, you would use 537.82 (Angiodysplasia of stomach and duodenum [without mention of hemorrhage]). Angiodysplasia is malformation of blood vessels in the gut. It is a common cause of otherwise unexplained bleeding and anemia.

The actual sites are called arteriovenous malformations (AVMs).

For the treatment, you'd use 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). The AVMs would fall into the category of "other lesions."

What is APC? Argon plasma coagulation uses a jet of ionized gas to coagulate the bleeding lesion.

What if: If the AVMs were bleeding, you'd use 537.83 (Angiodysplasia of stomach and duodenum with hemorrhage). The treatment code would be 43255 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method).