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EGD Coding

  1. #1
    Default EGD Coding
    Medical Coding Books
    Hi Im new to the coding profession and work for a general
    surgeon. Just wanted some help with coding for an EGD
    Procedure was as follows: Egd,cold bx & polypectomy of
    proximal gastric polyp and cold bx. (polypectomy was removed with cold bx bites) Thank you , cricket

  2. Default Egd
    You may want to look into CPT procedure code 43251 as it is similar to the below.

    Here is some information from the CPT assistant:

    Jan 1996:
    "Digestive System, 45380, 45385 (Q&A)

    Question:

    How do I code a flexible colonoscopy with removal of a POLYP using a COLD biopsy forceps? Would this be considered the same as a hot biopsy?

    AMA Comment:

    The appropriate code for a colonoscopy with removal of a POLYP by a COLD biopsy is 45380 or 45385 depending on the actual technique employed. CPT code 45380, Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple, should be reported for the removal of portions of the POLYP by COLD biopsy forceps. CPT code 45385, Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), POLYP(s), or other lesion(s) by snare technique, most accurately describes the removal of the entire POLYP using a COLD biopsy forceps. The jaws at the tip of the forceps (as opposed to a loop) surround the POLYP at its stalk and severe its attachment to the colon mucosa. The POLYPoid lesion is then sent for pathology analysis."

  3. #3
    Default
    I do GI coding and billing and from what you are telling me I would bill 43239 as the procedure code and 211.1 as the dx. Hope this helps!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  4. Default
    I code for a large GI practice and I agree, for the most part without seeing the op note, I would bill 43239 with dx 211.1 (if pathology comes back differently, cancer etc, I would use that dx code).


    Quote Originally Posted by scorrado View Post
    I do GI coding and billing and from what you are telling me I would bill 43239 as the procedure code and 211.1 as the dx. Hope this helps!

  5. Default
    I was asking he same question. In my case I have biopsy and also removal by cold biopsy forcep. I used the 43239 for the biopsy but wasn't sure about the removal. I think the 45385 sounds like a better choice

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