Gastroenterology Coding Alert

Another year, another Stretta code - but which one's the right one? It's official: The American Medical Association has released its final list of CPT codes for 2005, and it includes a smattering of new additions relevant to gastroenterology practices.

In last month's issue of Gastroenterology Coding Alert, we looked at several new codes that were slated to be included in the newest version of CPT. The AMA has since confirmed that all of the codes discussed in that article will indeed be part of CPT 2005.

This month, we will test you on the new gastro-relevant CPT 2005 codes. Less Learning Time = More Urgency With Codes Remember: You must begin using these codes on  Jan. 1, 2005, so practice using them now. Take the following quiz on new gastro-relevant codes in CPT 2005 before checking the answers below. (Note: All quiz answers appear, in some form, in the article "EUS, Fine Needle Colonoscopy Codes to Land in 2005" in the October Gastroenterology Coding Alert.)

1. When the gastroenterologist performs the Stretta procedure on a patient in 2005, you should report:

a. 0057T (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate, with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease)

b. 43499 (Unlisted procedure, esophagus)

c. 43257 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease)

d. 43259 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum and/or jejunum as appropriate) 2. Let's say your gastroenterologist is performing a colonoscopy. During the procedure, he biopsies a lesion through the wall of the colon using ultrasound pictures to guide the needle. In this instance, you should report:

a. 45391 (Colonoscopy, flexible, proximal to splenic flexure; with endoscopic ultrasound examination)

b. 45392 (Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy[s])

c. 45999 (Unlisted procedure, rectum)

d. 45342 (Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transluminal fine needle aspiration/biopsy[s]). 3. Consider this scenario: During a colonoscopy, the gastroenterologist sees a suspicious mass under the patient's intestine and decides to have a closer look. With the help of an ultrasound device attached to the colonoscope, the gastro views the suspicious area. In this scenario, you should report:

a. 45391 (Colonoscopy, flexible, proximal to splenic flexure; with endoscopic ultrasound examination)
b. 45999 (Unlisted procedure, rectum)

c. 45392 (Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy[s])

d. 45342 (Sigmoidoscopy, flexible; with transendoscopic [...]