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Thread: Ercp with sludge removal

  1. #1

    Default Ercp with sludge removal

    AAPC: Back to School
    Can any help with coding for an Ercp procedure where they remove sludge?

    The report states: The biliary tree was swept with a balloon starting at the upper third of the main bile duct. Sludge was removed. This was a patient that they thought had bile duct stones.

    Thank you

  2. #2


    43264 I the code you want. I was told that sludge = stones.

    Here is info from medterms.com:

    Biliary sludge can be looked upon as a condition of microscopic gallstones, although it is not clear at what size the particles in biliary sludge should be considered gallstones. More important than the differentiation by size is whether or not there are symptoms since symptoms of biliary sludge or gallstones are treated similarly.

    Similarly if they do the balloon sweeps and no stones or sludge are found/removed you would still code 43264 and add the 52 modifier.

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