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Gastroenterology Coding Alert

READER QUESTIONS:

Look for More Details on 'Mucosal Resection'

Published on Mon Mar 23, 2009

Question: What is the code for endoscopic mucosal resection? Kentucky Subscriber Answer: If your physician is removing a polyp or lesion, use the appropriate endoscopy code, such as 43251 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique). There is no procedure code for "endoscopic muscosal resection." A resection is just the partial removal of a bodily structure, in this case the lining of the esophagus, stomach, or intestines. It's less aggressive than an "-ectomy." Look to what's being treated to see if there's a more specific procedure code; if not, you may be stuck with an unlisted procedure such as 43499 (Unlisted procedure, esophagus). Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA's CPT Advisory Panel; and Linda Parks, [...]
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