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Gastroenterology Coding Alert

Reader Question:

EUS and Diagnostic Endoscopy -- Report Separately or With a Single Code?

Published on Tue Feb 14, 2012

Question: I am facing a reporting dilemma over here. My question is if a diagnostic endoscopy has been performed with an endoscopic ultrasound, how should it be reported? One of my colleagues says that both the procedures should be reported separately using a modifier, but I think only the endoscopic ultrasound should be reported. Who is correct?Oklahoma SubscriberAnswer: According to the CPT® manual, whenever a diagnostic endoscopy has been performed along with an endoscopic ultrasound (EUS), it should be reported with the CPT® code 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).This is according to the guidelines adopted by CPT® with respect to indented codes. As these guidelines indicate, the services mentioned in the indented codes of 43259 will cover the services mentioned in the unintended code [...]
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