Wiki EUS to obtain pancreatic biopsy

TTcpc

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Hello,

I need some assistance coding the following:

"echoendoscope was advanced into the esophagus and the aorta followed along its longitudinal axis to the origin of the celiac artery.The tail of the pancreas is characterized by diffuse glandular atrophy with cystic dilation of the ductal structures. A 19 gauge Cook ProCore needle was advanced into the cystic lesion which was aspirated to oblivion producing approximately 3 mL clear serosanguinous material; this was submitted for biochemistry."

Our coding department used 43231 and 10022; however I do not feel comfortable with this because a 19 gauge Cook ProCore needle is a bore needle not fine and would not qualify as fine needle aspiration. My thoughts are 43231 for the EUS along with 48102 for the pancreatic biopsy.

Please let me know if my thinking is correct. I am fairly new to GI coding and am second guessing myself on this.

Thank you!
 
My only issue with 48102 is it is not supposed to be used for endoscopic procedures. I agree it just does not seem correct to use the original codes however I am having a difficult time figuring out what to use for access via the celiac artery. I have only ever seen access to the pancreas via the pancreatic duct (ampulla of vater, etc.) so I am at a loss with this scenario.

I hope someone super-knowledgeable chimes in!
 
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