General Surgery Coding Alert

Question: Our surgeon performs a pre-bypass surgery EGD and notes acute esophagitis. What ICD-9 code should we list for the claim?

Virginia Subscriber

Answer: Because you must always report the most specific diagnosis, you should list the code for the esophagogastroduodenoscopy (EGD) findings: 530.12 (Acute esophagitis).

But you should also list ICD-9 codes to show the reason for the EGD as a pre-op procedure for gastric bypass surgery. Submit the following codes to document the reason for the test:

• 278.01 -- Morbid obesity
• V85.xx -- Body mass index ...
• V72.83 -- Other specified preoperative examination.

FYI: Many payers won't accept V72.83 as primary diagnosis, so reporting findings from the EGD is important. If no symptoms appear, listing obesity and BMI that show medical necessity for the bypass surgery serve to show medical necessity for the service.