I'll be interested in any discussion we can generate about this topic because I have had so many debates on this subject. Here are my thoughts:
CCI requires that we code the most comprehensive code and an example I use is the sigmoidoscopy / colonoscopy services and apply the same theory to EGD / enteroscopy services. The enteroscopy is more extensive than the EGD as the colonoscopy is more extensive than sigmoidoscopy. So, if a scope reaches the TI and a biopsy (or any intervention) is taken from the sigmoid colon, the colonoscopy with biopsy code is used. Therefore, if an enteroscopy is done, and a biopsy is taken from the esophagus or stomach, the enteroscopy with biopsy code is used.
Applying this theory to your coding scenario, I would code 44366-59, 44361.
Many physicians dispute this coding concept and are reluctant to code following this concept stating their intent was to do EGD or that enteroscopy requires a different scope.
I posed this question to the AMA through their "CPT Assistant," but they have not responded.
Any other thoughts?
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