Diagnosis question

[anknight77]

I have a patient that we did an ERCP with biliary stent removal (43269). They are taking it out because it is no longer needed. What diagnosis can I use for this that would be covered for Medicare? We originally used V44.8 but that was denied as not covered. Stent was originally placed for CBD stricture.

Thanks!
Amy

[salCCS]

I would use V53.5x

[bridgettemartin]

Take a look at v58.49. Depending on the Provider's documentation, we sometimes attach the indications for the stent.

[mitchellde]

it would be appropriate to use the V58.49 plus the 53.5x code, never use the code for why the stent was inserted when that condition has resolved. The dx is the patient's and the payer already has the information for the original surgery. Do not indicate that the problem still exisits by attach the reason the the stent was inserted. That only goes to raising the patient's risk.

[anknight77]

thank you!