Gastroenterology Coding Alert

Question: My doctor performed an esophagogastroduodenoscopy on a patient who had a food impaction at the gastroesophageal junction and pushed the food into the stomach. Can I bill for EGD with foreign body removal (43247), or does a physician have to actually remove a foreign body through the mouth?
Kansas SubscriberAnswer: If your physician was able to complete the EGD in spite of the food in the stomach, yes, you can use 43247 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body). It doesn't matter which direction the food goes.If your physician intended to perform a full EGD but was unable to after dislodging the food, your best bet would be to report 43247-52 (Reduced services).If your physician performed the scope just to dislodge the food, you would use 43215 (Esophagoscopy, rigid or flexible; with removal of foreign body).Document it: In any case, include a brief note on your claim explaining that the gastroenterologist dislodged the food into the stomach using the endoscope rather than removed the food from the patient.