Gastroenterology Coding Alert

Question: Which code applies when the physician places a duodenal stent during endoscopy?

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Answer: Stents are inserted endoscopically and used to hold open the lumen of the GI tract at the location it is released. Commonly, stents are used to preserve the esophageal lumen in cases of inoperable cancer. They also are used in other parts of the gastrointestinal system such as the colon and the duodenum. CPT^® has provided specific codes for the placement of stents in all these areas.

The placement of a duodenal stent through an upper gastrointestinal endoscopy (EGD) can be reported with code 43266 (Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)).

You also have a dedicated esophagoscopy stent placement code if a complete EGD is not performed. You would report code 43212 (Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)). Code 43266 could be reported if a complete EGD is performed and an esophageal stent is placed.

Similarly, for a colon stent placement, you should use codes 45327 (Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)), 45347 (Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)), 45389 (Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)), or 44403 (Colonoscopy through stoma; with endoscopic mucosal resection).