tholcomb
Networker
Good morning all,
I have a question about an EGD please see the procedure note below, cpt 43235 and 43236
can these be billed together?
Procedure: After obtaining informed consent including discussions of the risks benefits and alternatives to this procedure as well as the planned sedation the patient was placed in the left lateral decubitus position and begun on continuous blood pressure pulse oximetry and EKG monitoring and this was maintained throughout the procedure. Once an adequate level of sedation was obtained and after application of oral topical anesthetic a bite block was placed. We then inserted a lubricated tip of the Olympus-GIF-one 80 diagnostic video upper endoscope and advanced it using a direct visualization technique into the posterior pharynx and ultimately into the esophagus, stomach, and duodenum.
Findings:
Esophagus: The Z line was noted at 40 centimeters. The esophagus appeared normal throughout its entire length with no evidence of rings, webs or other luminal narrowing. There was no evidence of erosions, ulcerations or masses.
Stomach: We then entered the stomach. Gastric mucosa appeared normal in the forward view with no evidence of erythema, erosions or ulcerations. There was no evidence of any luminal or submucosal masses. A retroflexed view allowed examination of the angularis, cardia and fundus and these areas also appeared normal with a non-patulous cardia. No hiatal hernia was seen. The pylorus was injected with 4cc of botulinum toxin (1mg into each quadrant) with total of 100 units given.
Duodenum: We then entered the duodenal bulb. Mucosa of all 4 quadrants of the bulb appeared normal with no evidence of erosions, edema or erythema. No ulceration was noted. Likewise the second and third portions of the duodenum were normal.
Thank you
TH
I have a question about an EGD please see the procedure note below, cpt 43235 and 43236
can these be billed together?
Procedure: After obtaining informed consent including discussions of the risks benefits and alternatives to this procedure as well as the planned sedation the patient was placed in the left lateral decubitus position and begun on continuous blood pressure pulse oximetry and EKG monitoring and this was maintained throughout the procedure. Once an adequate level of sedation was obtained and after application of oral topical anesthetic a bite block was placed. We then inserted a lubricated tip of the Olympus-GIF-one 80 diagnostic video upper endoscope and advanced it using a direct visualization technique into the posterior pharynx and ultimately into the esophagus, stomach, and duodenum.
Findings:
Esophagus: The Z line was noted at 40 centimeters. The esophagus appeared normal throughout its entire length with no evidence of rings, webs or other luminal narrowing. There was no evidence of erosions, ulcerations or masses.
Stomach: We then entered the stomach. Gastric mucosa appeared normal in the forward view with no evidence of erythema, erosions or ulcerations. There was no evidence of any luminal or submucosal masses. A retroflexed view allowed examination of the angularis, cardia and fundus and these areas also appeared normal with a non-patulous cardia. No hiatal hernia was seen. The pylorus was injected with 4cc of botulinum toxin (1mg into each quadrant) with total of 100 units given.
Duodenum: We then entered the duodenal bulb. Mucosa of all 4 quadrants of the bulb appeared normal with no evidence of erosions, edema or erythema. No ulceration was noted. Likewise the second and third portions of the duodenum were normal.
Thank you
TH