Gastroenterology Coding Alert

Question: The gastroenterologist performs an upper gastrointestinal endoscopy (EGD) to control bleeding of a gastric ulcer (no perforation mentioned in notes). During the encounter, he also removes a pair of gastric varices. Can I report both EGDs, and if so, how? Kentucky Subscriber Answer: Yes you can, but you'll need to order the codes properly. On the claim, report the following: • 43244 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with band ligation of esophageal and/or gastric varices) for the ligation • 747.61 (Other anomalies of peripheral vascular system; gastrointestinal vessel anomaly) appended to 43244 to represent the patient's varices • 43255 (... with control of bleeding, any method) for the EGD • 531.4 (Gastric ulcer; chronic or unspecified with hemorrhage) appended to 43255 to represent the patients bleeding ulcer • modifier 59 (Distinct procedural service) appended to 43255 to show that it [...]