Wiki Egd injection vs. Control of bleed

[Aledford]

Okay I need HELP!!

I have this coding question I would really like the answer to, so please feel free to tell me if I am wrong, I do not agree with this.

Pt seen for Egd for possible GI Bleed. Operative report states, bleeding duodenal ulcer w/ possible visible vessel. Provider then makes several injections of epinephrine to these probable vessels.
Operative note states, "Operation Performed: Edg w/ epinephrine injection for control of hemorrhage"

No where in the operative report does it state any of the listed vessels were bleeding.

The coder posted charges as 43236, for the injection and 43239 for biopsies taken.
I get that you can not really bill for control of blled as he never states there was active bleeding, I am just not sure I agree w/ the billing for an injection when the intent was to control a bleed.

Do you think this is correct billing??

 

[blathrop19@gmail.com]

43255 EGD with control of bleed ANY METHOD. The contexo gastroenterology book states that epinephrine injection for control of bleed is covered by 43255 so I think you should be good to go with that. Also a hemorrhage is a discharge of blood so your good to go for bleeding on that. Hope this helps or makes sense for the case.

Bob

 

[JenReyn99]

I agree that 43255 would be the correct code. What I am seeing is that he was controlling the duodenal bleeding, but I don't have the whole op note, so I can't say that I'm 100% correct. It does say in what you posted that there was a bleeding duodenal ulcer. That's my 2 cents. :0)

 

[Aledford]

Let me add that the provider stating a bleeding duo ulcer with a possible visible vessel. In the note there are alot of possible and probable vessels, with the statement no active bleeding. I do not agree that a 43236 should have been billed, and there are to many possible/probable for me to bill a 43255.