AAPC - August DL Sale: 50% OFF
Results 1 to 2 of 2

Thread: ERCP with balloon sweep

  1. #1
    Join Date
    Apr 2007
    Location
    Atlanta
    Posts
    61

    Default ERCP with balloon sweep

    AAPC: CPC Promo
    This wording is confusing me. I know that I would code 43262 for the sphincterotomy but I want to code 43264 for the ballon sweep also but since stones are not mentioned I am hesitant to do so. Filling defects could justify the balloon sweep I believe but I am not totally sure. Any suggestions would be appreciated.



    PROCEDURE PERFORMED: Endoscopic retrograde
    cholangiopancreatography )ERCP) with sphincterotomy.

    INDICATIONS: Elevated liver enzymes.

    REFERRING PHYSICIAN:

    INSTRUMENT: Olympus duodenoscope.

    MEDICATIONS: Demerol 150 mg, Versed 6 mg IV, glucagon 0.75 mg, and
    Phenergan 25 mg IV.

    COMPLICATIONS: None.

    TECHNIQUE: The patient gave informed consent, after the risks and benefits
    were explained to the patient. The patient was placed in the prone
    position and conscious sedation was obtained using the above medication.
    The endoscope was introduced and advanced to the second portion of the
    duodenum under direct visualization.

    FINDINGS: The major papilla looked normal and there was unremarkable gas
    pattern on the scout film. The common bile duct was cannulated with .035
    guidewire, using a microvasive sphinctertome.

    CHOLANGIOGRAM: The initial cholangiogram showed a few filling defects, but
    were possibly air bubbles. An exchange with the balloon catheter was
    performed and an occlusion cholangiogram was performed with balloon sweep
    and that confirmed the ducts are clear. The ducts were normal size and
    there was no filling defects seen. Sphincterotomy was performed prior to
    the balloon sweep and the site was observed and there was no bleeding.
    There was no filling of the gallbladder during our cholangiogram. The
    pancreatic duct was not injected or cannulated.

    IMPRESSIONS:
    1. No filling of the gallbladder. Otherwise, normal cholangiogram.
    2. Status post balloon sweep that confirmed the ducts are clear.
    3. Status post sphincterotomy.

    RECOMMENDATIONS: Proceed with surgery for acute cholecystitis
    JOJO-CPC-H

  2. #2
    Join Date
    Apr 2007
    Location
    Charlottesville
    Posts
    8

    Default

    I would only bill the 43262-sphincterotomy. As the note states the balloon sweep confirmed the ducts are clear. No stones or sludge were removed.

Similar Threads

  1. ERCP with dilation without balloon
    By KJenkins588 in forum Gastroenterology
    Replies: 2
    Last Post: 09-30-2015, 09:08 AM
  2. Postpartum manual sweep of uterus
    By tobeornottobeacoder in forum OB/GYN
    Replies: 1
    Last Post: 02-02-2015, 11:50 AM
  3. Ercp
    By cingram in forum Gastroenterology
    Replies: 0
    Last Post: 08-26-2011, 05:36 PM
  4. ERCP w/ spinct, balloon dil, stone rem. and stent
    By jojogi in forum Gastroenterology
    Replies: 2
    Last Post: 08-07-2011, 10:23 PM
  5. ERCP Balloon Sweep no stone/sludge
    By JamieAnderson in forum Gastroenterology
    Replies: 1
    Last Post: 06-22-2011, 11:02 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.