Advanced Search

Gastroenterology Coding Alert

Reader Questions:

43235 and 91035 Work Hand-in-Hand

Published on Tue Sep 21, 2010

Question: A gastroenterologist sees a new patient complaining of frequent belching and heartburn. She performs a level-two E/M service, and subsequently, a diagnostic EGD. During the EGD, she also inserts a Bravo capsule and performs a reflux test. The test results came back negative for both cancer and gastroesophageal reflux disease (GERD). Can I report the EGD and Bravo insertion separately?New Mexico SubscriberAnswer: Yes. You should be able to code the EGD and Bravo capsule insertion using 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic,with or without collection of specimen[s] by brushing or washing [separate procedure]), and 91035 (Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation), respectively.Here's what you should report for the rest of your claim: 99202 -- Office or other outpatient visit for the evaluation and management of a new patient, which requires these [...]
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