Wiki ERCP billing with sphincterotomy

[jwbcoder]

My doctor did a ERCP, biliary sphincterotomy, biliary sphincteroplasty, common bile duct stone extraction and a placement of a 10-French plastic common bile duct stent. I need help with coding this please! Any suggestions would greatly be appreciated. Thanks!

 

[Angeleke]

I think its the 43274 and either 43262 or 43264. I coding this from memory so verify the codes . My doctors do this procedure in the hospital all the time. Im not that certain but this should point you in the right direction.

 

[MAult142]

Be careful with 43274 and 43262 together. You can't bill a stent placement with a sphincterotomy if they were both in the same duct. If it's the same duct, the 43262 is considered part of the 43274. You can bill the 43264 for the stone removal with either the 43274 or the 43262.

As for the sphincteroplasty...I don't have a lot of experience with that, but maybe take a look at code 47460? I don't know the billing restrictions associated with that code. From the description, it sounds like 43262 and 43264 could be included in it?