General Surgery Coding Alert

Question: Our surgeon performed an endoscopy, viewing the esophagus, stomach, and duodenum before identifying and removing a blockage containing a small ball from a child's jejunum. Should we report 43247 since the code states either duodenum and/or jejunum?Tennessee SubscriberAnswer: No, the correct code for the foreign body removal in the jejunum is 44363 (Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body). Although 43247 (Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as appropriate; with removal of foreign body) states"duodenum and/or jejunum as appropriate," the code takes into account situations where the stomach enters directly into the jejunum due to a prior bypass procedure.Anatomy refresher: The small intestine begins with the duodenum (about 12 inches) before connecting with the jejunum (about 8 ft.) and finally the ileum (about 11 ft.). For a child without altered anatomy, you should [...]