Gastroenterology Coding Alert

Question: Our gastroenterologist is often called in to assist with the interpretation and supervision of the cholangiogram during an endoscopic retrograde cholangiopancreatography (ERCP). While this is bundled into the procedure code for the gastroenterologist performing the ERCP, can our gastroenterologist bill separately
for assisting?

Utah Subscriber

Answer: The gastroenterologist can bill separately for his assistance if a radiologist is not present, says Pat Stout, CMC, CPC, an independent gastroenterology coding consultant and president of OneSource, a medical billing company in Knoxville, Tenn. Gastroenterology coders have to be careful, however, that there isnt a radiologist billing the same code, she warns. Payers will not reimburse both.

The gastroenterologist performing the ERCP cannot bill separately for the cholangiogram, so there will also have to be some rationale for why a gastroenterologist was called in to provide assistance, Stout says. The gastroenterologist also needs to prepare a report of his or her interpretation that is separate from the procedure report of the endoscopist.

In this situation, Stout suggests reporting 74300 (cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation).