Wiki Small bowel bx into third portion of duodenum

[VFarrell]

The doctor performs a EGD and goes into the small bowel past the 2nd portion of the duodenum into the 3rd and does a bx there for celiac testing. How would you code this?

 

[j.berkshire]

I have had numerous discussions about this with many physicians and coders. The code I suggest to use when the scope passes D2 and a biopsy is taken is 44361. The base code, 44360, describes this family of codes as an enteroscopy beyond second portion of duodenum. Many physicians are reluctant to use the enteroscopy code for a number of reasons, but my response always goes back to the description of the code. Anyone else have input?

 

[VFarrell]

The egd with bx 43239 then 44361 - 59 ? Per CCI edits this appears to be acceptable with modifier.

 

[j.berkshire]

With the scenario you provide, only 44361. This is comporable to a colonoscopy with biopsies in the sigmoid colon; you would not bill colonoscopy with sigmoidoscopy with biopsy, only colonoscopy with biopsy.

 

[VFarrell]

thank you!

 

[VFarrell]

clarification - if he does bx in stomach and 3rd portion of small bowel its still just a 44361? Thanks.

 

[Barbara Hart]

the doctor performs a egd and goes into the small bowel past the 2nd portion of the duodenum into the 3rd and does a bx there for celiac testing. How would you code this?

44361