Athens, GA
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I need guidance on how to properly code a G-POEM procedure
Procedure: Gastric Peroral Endoscopic Myotomy (G-POEM)
Indications: For endoscopic myotomy, For therapy of gastroparesis
Mucosotomy followed by myotomy were performed in a posterior orientation. First, a submucosal injection of a solution of methylene blue and saline was used to lift the mucosa at the site of the initial mucosotomy. The initial mucosal incision was made longitudinally using a HybridKnife T-Type in the distal antrum about 5cm proximal to the pylorus. Next, the endoscope with a clear cap was used to enter into the submucosal tunnel. The submucosal tunnel was then further created by continued dissection, once the pylorus was clearly identified the myotomy was started using a HybridKnife T-Type to perform a complete pyloromyotomy. Intra procedure bleeding was minimal. A small Coagrasper was used effectively for hemostasis. After completion of the myotomy, there was no evidence of bleeding noted on the inspection of the myotomy edges and submucosal tunnel. The myotomy was successfully performed. The muscular division was complete. The mucosal entrance to the submucosal tunnel was closed using endoscopic clips.
Then ................ here for EGD with GPOEM. Pyloromyotomy was successful without complications.

You would not use 43497 because this is for the POEM procedure used to treat achalasia. Our coder is using 43999 unlisted procedures of the stomach and then referencing 43800 Pyloroplasty as the CPT code. Any guidance that you can offer will be helpful.
I think it is going to be the 43999 but I think I would still reference the 43497 (for technique explanation) but explain it was for gastroparesis at the pylorus not for achalasia at the esophagus or GE junction.