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Thread: Need resource for correct coding of esophagoscopies

  1. #1

    Default Need resource for correct coding of esophagoscopies

    AAPC: Back to School
    I am billing for an ASC. I have found great documentation for billing colonoscopies, but not the EGDs. Can anyone recommend a website?

  2. #2
    Join Date
    Apr 2007


    One valuable resource that has specific descriptions of all endoscopy codes is the "CPT Assistant," Spring 1994 issue. It's 15 years old, but the information is still good. There is also a "CPT Assistant" from October 2008. In essence, the method for billing EGDs is similar to billing for colonoscopy: the code family depends on how far the endoscope is passed. Once the family is determined, then the therapeutic and/or diagnostic services are chosen from that family. For example, examination of the esophagus and stomach is billed from the family of esophagoscopy, 43200; when the scope passes the pylorus, the service is from the family of EGD, 43235; when the scope passes the 2nd portion of the duodenum, the service is from the enteroscopy family 44360, and when the scope reaches the ileum, 44376.

    You can order back issues from the AMA from this link: https://catalog.ama-assn.org/Catalog...sue_search.jsp
    Last edited by j.berkshire; 09-22-2009 at 06:49 AM. Reason: added info
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    Join Date
    Apr 2007


    Another thing to know about EGD's is that just because the scope passes the second portion of the duodenum does not automatically make it an enteroscopy. With the advancement of technology and scopes, getting past the second portion of the duodenum is not the big deal that it used to be. An enteroscopy is a more complex procedure than an EGD so use your discernment in cases where the scope is not significantly past the second portion. Also, unguided esophageal dilations often bundle into through the scope "TTS" dilations so be sure to check NCCI edits.
    Juanita Mendoza, CPC

  4. #4


    Thanks for the guidance. I have been doing mostly ortho and pain management, it takes a while to get back into the GI groove.

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