JacinthaCP
Guest
Please correct the codes for ERCP done by my Provider for Outpatient in the Gastroenterology Dept at the Hospital:
43274
43264 59
74320 26 59
Luminal: The side-viewing duodenoscope was passed through the mouth and advanced with ease to the 2nd portion of duo. The major pailla had a prominent, bulging appearance. ERCP was performed.
Biliary/Pancreatic: The major papilla had a very prominent, markedly bulging appearance with a small polypoid lesion near the orifice but without evidence of intraduodenal tumor. Scout radiograph was normal. Biliary cannulation was achieved using a sphincterotome over a 025 guidewire. Cholangiogram revealed diffuse bile duct dilation, with suspicion of distal CBD filling defects and a stricture in the terminal CBD (versus sphincter segment,) but appeared more like a short segment stricture. A 10 mm sphincterotomy was performed at the biliary orifice using an Erbe blended current device. There was no significant bleeding. A large amount of villous, polypoid appearing tissue protruded from the papilla following sphincterotomy. A small amount of black stone debris exited spontaneously, and additional stone debris was removed with balloon sweeps. Multiple cold forceps biopsies were taken from the villous tissue and sent for histology. A 10 Fr by 5 cm straight, plastic biliary stent was placed. The stent was in good position and there was good drainage of contrast and bile. The gastric antrum ulcers (anterior and posterior wall) were biopsied with a cold forceps for histology.
Maneuvers: Biliary cannulation was performed. Biliary orifice sphincterotomy was performed. Stone removal. Ampullary biopsies taken. Biliary stent placed.
43274
43264 59
74320 26 59
Luminal: The side-viewing duodenoscope was passed through the mouth and advanced with ease to the 2nd portion of duo. The major pailla had a prominent, bulging appearance. ERCP was performed.
Biliary/Pancreatic: The major papilla had a very prominent, markedly bulging appearance with a small polypoid lesion near the orifice but without evidence of intraduodenal tumor. Scout radiograph was normal. Biliary cannulation was achieved using a sphincterotome over a 025 guidewire. Cholangiogram revealed diffuse bile duct dilation, with suspicion of distal CBD filling defects and a stricture in the terminal CBD (versus sphincter segment,) but appeared more like a short segment stricture. A 10 mm sphincterotomy was performed at the biliary orifice using an Erbe blended current device. There was no significant bleeding. A large amount of villous, polypoid appearing tissue protruded from the papilla following sphincterotomy. A small amount of black stone debris exited spontaneously, and additional stone debris was removed with balloon sweeps. Multiple cold forceps biopsies were taken from the villous tissue and sent for histology. A 10 Fr by 5 cm straight, plastic biliary stent was placed. The stent was in good position and there was good drainage of contrast and bile. The gastric antrum ulcers (anterior and posterior wall) were biopsied with a cold forceps for histology.
Maneuvers: Biliary cannulation was performed. Biliary orifice sphincterotomy was performed. Stone removal. Ampullary biopsies taken. Biliary stent placed.