Gastroenterology Coding Alert

Endoscopic Retrograde Cholangiopancreatography:

43262-43269 Is Your Guide to Profitable ERCP Coding

Get paid twice the $440 rate for 43268. Find out how.If you think coding for endoscopic retrograde cholangiopancreatography (ERCP) is a simple one-code affair, you're mistaken. If your gastroenterologist performs a sphincterotomy, gallstone lithotripsy, stent placement, or a fluoroscopy, you can mix and match the different ERCP CPTs without any consequences -- except, perhaps, a much welcome added dollars to your reimbursement.Read through the following 3 frequently asked questions and get no-nonsense advice straight from the experts. FAQ 1: Should I Mind 43268, 43262 Bundles?When your gastroenterologist performs a pancreatic stent placement during an ERCP with sphincterotomy, you can bill for two CPTs on your claim: 43268 (Endoscopic retrograde cholangiopancreatography; with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct) in addition to 43262 (Endoscopic retrograde cholangiopancreatography; with sphincterotomy/papillotomy).And you don't have to worry about using any modifier as no such is required, according to Jennifer Lawrence, CPC, [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Gastroenterology Coding Alert

View All