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ERCP- Help!

  1. #1
    Default ERCP- Help!
    Medical Coding Books
    Sometimes I am confused on when to use the 43260 with other codes. For this I think I should use 43260-59, 43262, 43264, 43265. I looked on the CMS website and based on the MUE chart this is what I came up with. Please advise.

    ENDOSCOPY REPORT ----

    TECHNIQUE: AFTER OBTAINING INFORMED CONSENT, THE PATIENT WAS PLACED IN THE
    PRONE POSITION. BITE BLOCK INSERTED INTO THE ORAL CAVITY. CONSCIOUS
    SEDATION ADMINISTERED. OLYMPUS VIDEOSCOPE WAS PASSED THROUGH THE
    OROPHARYNX TO ESOPHAGUS THEN ADVANCED TO THE SECOND PORTION OF THE
    DUODENUM.

    FINDINGS: THE PYLORUS APPEARED WITHIN NORMAL. THE MAJOR PAPILLA WAS
    CANNULATED AND THE CHOLANGIOGRAM WAS OBTAINED WHICH SHOWED DILATED COMMON
    BILE DUCT WITH DIAMETER 12 TO 13 MM, AS WELL AS DILATED INTRAHEPATIC DUCTS.
    A FILLING DEFECT WAS NOTED IN THE DISTAL COMMON BILE DUCT, MOSTLY
    CONSISTENT WITH COMMON DUCT STONE. A SPHINCTEROTOMY WAS PERFORMED WITH
    DRAINAGE OF SLUDGE AND DEBRIS AS WELL AS PURULENT MATERIAL. MULTIPLE
    BALLOON SWEEPS WERE THEN PERFORMED WITH RETRIEVAL OF SLUDGE AND DEBRIS,
    HOWEVER, ON REPEAT CHOLANGIOGRAM, THE FILLING DEFECT WAS STILL NOTED IN THE
    DISTAL COMMON BILE DUCT. THEREFORE, AN EXTRACTION BASKET WAS USED FOR
    LITHOTRIPSY AND THIS WAS SUCCESSFUL. A REPEAT CHOLANGIOGRAM AFTER
    LITHOTRIPSY SHOWED NO FILLING DEFECTS WITHIN THE BILIARY TREE.

    IMPRESSION:
    1. STATUS POST SUCCESSFUL SPHINCTEROTOMY.
    2. CHOLEDOCHOLITHIASIS, STATUS POST SUCCESSFUL LITHOTRIPSY.
    3. DILATED COMMON BILE DUCT AND INTRAHEPATIC DUCTS.
    JOJO-CPC-H

  2. #2
    Default
    43260, the base code for the ERCP family, cannot be billed with the other ERCP-family codes; it is considered part of the description of all the codes in the family. I suggest coding this report with 43262, 43264, 43265.
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    Default
    Thanks again!
    JOJO-CPC-H

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