Wiki EGD w/ Biopsy and Colonoscopy w/ Biopsy

[sbwilkes81]

Op report:

EGD w/ biopsy of 8mm stomach ulcer and Duodenum to rull out Celiac. Colonoscopy w/ biopsy.

Procedure was coded:
45380
43239
44100 ??

I was told by the practice that the 44100 could be billed in addition to the EGD? I have talked to a couple other coders, because I am not specialized in GI scopes!!, and they have both told me this is wrong. I wanted to see if I could get something in writing!

Thank you!

 

[koatsj]

I found this article at supercoder.com.....
Gastroenterology Coding
Gastroenterology offices will be most affected by four new NCCI bundles. Here is a look at these new bundles and what you need to look for to eliminate improper filings and maximize payment in light of the new edits.
NCCI Brings Biopsy Bundles to Esophagoscopy
The procedures NCCI has bundled into 43239 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple) will likely shock no one. When an esophagoscopy is performed, all stomach or intestinal biopsies conducted during it should be bundled into 43239. This edit removes all doubt about billing 43600 (Biopsy of stomach; by capsule, tube, peroral [one or more specimens]) or 44100 (Biopsy of intestine by capsule, tube, peroral [one or more specimens]) in addition to the endoscopy (or esophagogastroduodenoscopy).

"These are not surprising, and I can't imagine that anyone would bill both codes - except to game the system," says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and a former member of the CPT advisory panel. Although these edits all have an indicator of "1" - meaning that the procedures can be separately reported for a single patient encounter that meets certain criteria - Weinstein doesn't think they would apply in most situations.

For me personally, I have never billed CPT 44100 in addition to CPT 43239.
I hope this helps.....