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General Surgery Coding Alert

Upper GI Endoscopy; Support EGD or Enteroscopy Choice With Medical Necessity

Published on Sat Apr 03, 2010

Don't upcode incidental jejunum peek.Not every endoscope that goes beyond the proximal duodenum warrants enteroscopy codes -- sometimes esophagogastroduodenoscopy (EGD) may be the right option despite "going the distance."Bonus: When you code correctly by ignoring an "incidental" look to the jejunum, you just might garner a monetary reward for your general surgeon's work.Learn Codes' AmbiguityLook at the following codes for push enteroscopy and EGD, and you'll see that "how far" isn't the only key to these codes:›› 43235 -- Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)›› 43239 -- ... with biopsy, single or multiple›› 44360 -- Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)›› 44361 -- ... with biopsy, single or multiple.Key: Although the definitions overlap regarding whether the surgeon [...]
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