Hi Tamcamp & orazzals, Since your forum posts are pretty old, presumably you have had to figure this out for yourselves. There's a later string in the blog that supports 48999 and comparable CPT 48105, which is what I am coding now. There does not seem to be any progress on using 48999 because the parenthetical note under 43240 still says "For endoscopic pancreatic necrosectomy use 48999." When billing for the endoscopic surgeon, he is required to provide a comparable CPT for the claim comment area and the surgery charge is based on the comp code. The surgeon has indicated that 48105 is his comp code. It is common practice to use the open procedure code for unlisted laparoscopic procedures, so using the open CPT for an endoscopic px is just following that tradition. The GI Lab Reports for this procedure are sadly lacking support for such a "big" code, however, and I am looking for a sample op report that provides sufficient detail to be favorably reviewed when submitted with 48999. In my experience, all unlisted CPT's are manually reviewed at some point: claims with a comparable code in the documents and an op report are usually paid quickly (to meet prompt payment rules), but may be subject to claw back if the manual review is unfavorable. If possible, can either or both of you share your op reports here and how your reimbursement was using the note?