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Wiki Balloon Sweeep w/o Removing Stones

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kathleenjean84

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Can we bill for a 43264 when they discover no stones present? Or can we bill with a 52 reduced services modifier? The doctor still did the procedure, there just wasn't any stones present. Thanks from Digestive Health Associates of Southwest Michigan!
 
Ercp

During ERCP, it is routine to do a sweep to make sure the ducts are clear.
In the event that sludge and stones were removed.... charge 43264.
I would not use 43271 unless it is specifically documented that the bile duct and / or pancreatic duct was dilated during the procedure. If there are no stones, I would use 43260.

Mary Jo Russman, CPC, CGIC, CMC
Cleveland Clinic Digestive Disease Institute
 
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