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Wiki EGD and Colonoscopy same surgical case

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mdwyer

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Often a patient will have an EGD done the same day as a diagnostic colonoscopy. Since the physician always starts with the EGD, we have always coded the EGD as primary procedure and the colonoscopy as second.

We have now been asked to code the colonoscopy first for reimbursement purposes. Is there any guidelines that state what order multiple procedures need to be coded in or are we okay doing the colonoscopy codes first even if the physician started with the EGD?
 
It is always a diagnostic EGD and most often a diagnostic colonoscopy. Every now and then it is a diagnostic EGD and a screening colonoscopy.
 
You put them in order of WRVU's. A colonoscopy holds a higher RVU than an EGD so the colonoscopy should be listed first and then you need a modifier on the EGD.
 
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