Wiki Endoscopy code-help

[burgmeit]

I AM LOOKING FOR A CODE FOR UPPER ENDOSCOPY W/DUODENOSCOPE AND SMALL BOWEL ENTEROSCOPY. PLEASE HELP!!

 

[coachlang3]

The upper EGD is considered part of the SB enteroscopy (44360 series). But before someone can help you with the code we would need to know what was done.

 

[burgmeit]

With the patient in the left lateral decubitus position,
duodenoscope was passed to the third portion of the duodenum. The scope
was
then withdrawn. There was no blood in the upper GI tract.
Ampulla was identified. Just adjacent to the ampulla was a flat concave
disk-like lesion. The surface of this was not ulcerated nor was there a
visible vessel. There was no evidence that this lesion bled. There was
nothing in the stomach or esophagus that was obvious that could have bled.
A pediatric variable stiffness colonoscope was then inserted into the
esophagus, passed into the gastric lumen then into the small bowel.
When the scope got to the proximal jejunum, there was fresh blood
identified. I passed the scope beyond the blood which appeared to be
beyond the ligament of Treitz. The scope was withdrawn back into the area
where there was blood. This area was flushed using a washing machine. Once
I did clear the area, there was an obvious tumor in the proximal jejunum.
The surface of which revealed a small nipple-like lesion which represented
a visible vessel. I did biopsy a side of this lesion for diagnostic
purposes.
Because of the recurrent bleeding, I then injected the area around and
then
in the center of the visible vessel with epinephrine. A total of 10 cc of
1:10,000 epinephrine were injected. The area around the lesion and in the
center of the lesion was then injected with absolute alcohol. A total of
0.9 cc of absolute alcohol was injected. There was no bleeding at the end
of the procedure. Multiple pictures were taken. The more proximal lesion
in
the duodenum was not biopsied.