Barbara A. Love
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Could someone please clarify the difference between CPT codes 43235 (EDG) and 44360 (Enteroscopy). If our physician performs an EGD and documents advancing the endoscope to the third or fourth portion of the duodenum and documents an evaluation of all portions along with findings, which code is appropriate? The confusion is due to the wording "an either the duodenum and/or jejumum as appropriate" in 43235 and "enteroscopy beyond second portion of duodunum" in 44360. The codes appear to overlap.
Our physicians explain that their "intent" is to do a EGD. Clinically they are being thorough when they go "beyond the second portion of the duodenum". The coder is coding all EGD's that document "beyond the second portion of the duodenum" as enteroscopies. The physicians state that if they are going to perform a enteroscopy, then they will document that and will only be looking in the small bowel.
Hopefully I am not confusing anyone, I happen to agree with the physicians (I might be wrong) that their intent is to do a EGD and not look at the small bowel so regardless on where they went, it should be coded as a EGD.
Thanks in advance for all the help.
Respectfully,
Barbara A. Love, CPC,CPC-H,CMSCS,CBCS
Our physicians explain that their "intent" is to do a EGD. Clinically they are being thorough when they go "beyond the second portion of the duodenum". The coder is coding all EGD's that document "beyond the second portion of the duodenum" as enteroscopies. The physicians state that if they are going to perform a enteroscopy, then they will document that and will only be looking in the small bowel.
Hopefully I am not confusing anyone, I happen to agree with the physicians (I might be wrong) that their intent is to do a EGD and not look at the small bowel so regardless on where they went, it should be coded as a EGD.
Thanks in advance for all the help.
Respectfully,
Barbara A. Love, CPC,CPC-H,CMSCS,CBCS