Wiki EUS with fine needle biopsy of liver

Nancy Klein

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Hi,
Can someone assist with the coding of this op report. I'm guessing for the seasoned GI coder this is a piece of cake.

Procedure: EUS with fine needle bx of liver.

"...After adequate sedation, linear echoendoscope was inserted into the oropharynx. Scope was advanced with partial visualization to the distal GE junction. Celiac axis was seen. Scope was further advanced and pancreatic parechyma was seen. Pancreatic parenchyma neck, body and tail looked unremarkable. PD in the neck, body and tail looked unremarkable. The scope was rotated and left lobe of the liver was seen. Left lobe of the liver seen hyperechoic. A 22 gauge needle was passed through the scope and 4 passes were made and good cores were obtained. Scope was withdrawn."

Is this 43232 or 43238? How do you know that US was performed on which GI areas? Is the GE junction considered esophagus or stomach? I have two cases with the same operative report. The physician's billing department billed 43232 for both patients. The hospital billed 43238 on one of them and 43232 on the other????
 
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