Gastroenterology Coding Alert

Question: I am about to file one claim for a diagnostic colonoscopy and another for a diagnostic esophagoscopy. During a budget meeting last week, one of our gastroenterologists wondered aloud whether we could code for the supply of brushes used in these procedures. Is there any way to get payment for the brushes our gastroenterologists use in colonoscopies and esophagoscopies?

New York Subscriber
 
Answer: Unfortunately, no. The CPT codes for colonoscopies, esophagoscopies and upper gastrointestinal endoscopies (EGDs) already include all the payment you're going to get for brushes.
 
The same goes for endoscopic biopsy forceps, snares, balloons, needles, etc. All of these supplies are included in the facility reimbursement if the physician performs the procedures at a facility - or in the site-of-service differential if the physician performs the procedures in the office.
 
Claim 1: For the diagnostic colonoscopy, you should report only 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]).
 
Claim 2: For the diagnostic esophagoscopy, you should report only 43200 (Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]).