Wiki coding for Bipolar cauteruy and epinepherine injection

[pscar]

Dr. note says: the duodenal bulb revealed a single large 1.2 cm white based ulcer that was not actively bleeding, but had two visible vessels obviously present. These were treated with bipolar cautery as well as epinephrine 1:10,000 injections, 0.5 mL per visible vessel to obtain hemostasis. I have chosen 43250 and 43236 is this correct?

 

[ksschroeder]

I use 43270 instead of 43250 for these circumstances. I understand the code descriptions to mean that 43250 should be used for hot forceps or bipolar cautery when that is the means of removing tissue that will be sent to pathology (such as a polyp) and 43270 to be the code to use when the tissue is destroyed but not salvaged for pathology (such as ablation of visible vessels). Another reason; 43270 replaces 43258 and in the absence of active bleeding or signs of recent bleeding 43258 is what I would have used in the past for this procedure.
I would also bill 43236 for the injection in these circumstances.

 

[pscar]

thank you!