Gastroenterology Coding Alert

Medical necessity should be the governing factor -- not depth or scope type If you're routinely coding every scope procedure your gastroenterologist performs as a push enteroscopy, your coding could land you in hot water. The catch: Just because your gastroenterologist goes past the proximal duodenum doesn't mean you should always report an enteroscopy (44361, Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple). Sometimes an esophagogastroduodenoscopy (EGD) code, such as 43239 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple), is the correct code to report. Follow this expert advice to ensure you're choosing the proper scope code every time, and bring in the reimbursement your gastroenterologist deserves. Confirm Clinically Indicated Depth Before Coding Clinical practice doesn't necessarily equate to coding. You can only bill for how far the physician goes if [...]