Gastroenterology Coding Alert

READER QUESTIONS:

Coding EGD on Gastric Bypass Patients Can Get Tricky

Question: How should I bill an endoscopy for a patient who has had a gastric bypass procedure?


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Answer: Because the jejunum and duodenum are no longer attached to the stomach and cannot be reached by endoscopy, you may be tempted to report 43200 (Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]).

But this procedure is still an EGD, so the correct option is 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]).