Advanced Search

Gastroenterology Coding Alert

Reader Question:

Capture EGD Codes for Status Post Gastric Bypass Assessment

Published on Wed Sep 12, 2012

Question: Our gastroenterologist recently performed an EGD to assess complaints of abdominal pain for a patient who had previously undergone a gastric bypass? The procedure notes read, "Surgical "ring"from anastomotic pouch was reached endoscopically. Blind pouch measured approximately 10 cm. The efferent, true limb was traversed. Approximately 40cm from the efferent limb's opening, bile was visualized. The Roux anastomosis was not seen. Can you help by letting me know what code I should report for this procedure?Michigan SubscriberAnswer: Since your gastroenterologist is assessing the patient for his abdominal complaints by performing an upper EGD, you will have to report the procedure with the upper EGD code. As according to the procedure notes it can be inferred that he is only visualizing the gastrointestinal tract for complications of his gastric bypass, you will have to report the procedure with 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or [...]
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