Gastroenterology Coding Alert

READER QUESTIONS:

Use Benign-Lesion Code for Stoma Repair

Question: Our gastroenterologist treats a patient who has a gastrostomy tube. The op note says the patient has "some issues with granulation tissue at the stomal site that gets irritated and bleeds." The physician performed "argon plasma photoablation of granulation tissue at stomal site." How should I code this diagnosis and procedure? Delaware Subscriber Answer: Use code 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery,surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) for the procedure. Link that to a diagnosis of 701.5 (Other abnormal granulation tissue). Code 17110 doesn't specifically mention plasma ablation, but the wording doesn't rule it out, either.Gastroenterologists usually use argon plasma coagulation -- jet of ionized gas-- to treat bleeding inside the body.
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