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Gastroenterology Coding Alert

CCI 15.3 Update:

: CCI 15.3 Update: Watch for Fluoro, Moderate Sedation Bundles or Face Denials

Published on Wed Sep 23, 2009

Tip: Modifier 26 may be your key to separate reimbursement for professional services. If you thought you might be able to report 76000 or 76001 with an upper GI endoscopy or a proctosigmoidoscopy, the latest edition of the Correct Coding Initiative (CCI) edits should change your mind. Consider Fluoro Intrinsic to These Gastro Procedures You have long known that fluoroscopy is included in procedures, such as endoscopic retrograde cholangiopancreatography (ERCP) and gastro tube placements. CCI version 15.3, effective Oct. 1, extends the fluoroscopy bundles to more than 185 codes. You should now include 76000 (Fluoroscopy [separate procedure], up to 1 hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy) and 76001 (Fluoroscopy, physician time more than 1 hour, assisting a nonradiologic physician [e.g., nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy) in this partial list of codes: • Esophagus endoscopy codes 43200-43232 • Upper GI endoscopy codes 43234-43259 • Esophagus lap [...]
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