bridgettemartin
Expert
Thought this had been discussed before, but didn't find it on a search.
Pt is S/P gastric bypass with suspected CBD stone. Due to prior attempt and inability to reach the ampulla, a General surgeon from another practice creates a gastrostomy. During the same operative session, my GI Dr does the ERCP through the gastrostomy. It's limited, as he can't acces the bile duct, but he does do a pancreatic sphincterotomy and stent placement. The other surgeon goes on to place a G-tube and some other things, and his note states my Dr. will dictate his ERCP separately. My question: Is the ERCP still a 43260 series code? He used an endoscope, but didn't access through the mouth. When I look at the definition of base code 43260, it doesn't really state esophagus through doudenum. I've also looked at 47552, but my surgery book states this is directly into the biliary system through a T-tube or other drainage tract. No mention of sphincterotomies or stents, so I'm thinking this is not right. And, would modifier 62 be the most appropriate? Any thoughts?
Pt is S/P gastric bypass with suspected CBD stone. Due to prior attempt and inability to reach the ampulla, a General surgeon from another practice creates a gastrostomy. During the same operative session, my GI Dr does the ERCP through the gastrostomy. It's limited, as he can't acces the bile duct, but he does do a pancreatic sphincterotomy and stent placement. The other surgeon goes on to place a G-tube and some other things, and his note states my Dr. will dictate his ERCP separately. My question: Is the ERCP still a 43260 series code? He used an endoscope, but didn't access through the mouth. When I look at the definition of base code 43260, it doesn't really state esophagus through doudenum. I've also looked at 47552, but my surgery book states this is directly into the biliary system through a T-tube or other drainage tract. No mention of sphincterotomies or stents, so I'm thinking this is not right. And, would modifier 62 be the most appropriate? Any thoughts?