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Gastroenterology Coding Alert

READER QUESTIONS:

EGD With Endo Clip: The Code That Wasn't There

Published on Sat Feb 05, 2005

Question: I'm stumped. The operative notes for this encounter indicate that my gastroenterologist saw a patient vomiting blood. The gastro used a heater probe during an upper gastrointestinal endoscopy and placed two endoscopic clips. How should I report this encounter?


Alaska Subscriber


Answer: Since no code now exists for the placement of endoscopic clips, you should use a control-of-bleeding EGD code. On the claim:
 

  •  report 43255 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method) for the EGD.
     
  •  attach ICD-9 code 578.0 (Hematemesis) to 43255.

    Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, independent coding and billing consultant in Marietta, Ga.

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