Results 1 to 2 of 2

enteroscopy or colonoscopy

  1. #1
    Default enteroscopy or colonoscopy
    Medical Coding Books
    This makes no sense to me, but my docs are asking to bill an enteroscopy (44376) even though they are not approaching the ileum thru the mouth. They are calling it a "Lower device-assisted Enteroscopy.

    " the scope was passed under direct vision using the balloon-assisted technique. The EN-450T5 Enteroscope was introduced through the anus and advanced to the distal ileum. The lower device-assisted enteroscopy was performed with difficulty due to significant looping, the patient's body habitus and the nature of the procedure"
    "The colon (entire examined portion) appeared normal. A few diverticula were found in the sigmoid colon. The exam was otherwise normal throughout the examined colon.The
    terminal ileum appeared normal. The enteroscope was advanced into the distal ileum (approximately 40cm proximal to the IC valve), however secondary to looping, further advancement of the enteroscope/double balloon apparatus was unsuccessful and resulted in the enteroscope falling back into the cecum

    I think this should be billed with a colonoscopy code, maybe with a 22 modifier or an unlisted code.

    Any suggestions?

  2. #2
    Atlanta Perimeter
    I agree with you. I wouldn't bill an enteroscopy because of the rectal approach.

    The enteroscopy codes imply approach through the mouth & visualization of the stomach and small bowel to the ileum.

    If the physician approaches through the rectum and reaches only to the ileum then he is NOT seeing everything between the ileum and the mouth that would have been seen with the conventional approach. Hence, it is NOT an enteroscopy.

    I would bill the colon with a 22 modifier and send detailed documentation with the claim.
    Elizabeth Escalante, CPC
    Operations Manager
    Atlanta Gastroenterology Associates

Similar Threads

  1. enteroscopy
    By ppoole in forum Gastroenterology
    Replies: 0
    Last Post: 07-16-2014, 11:06 AM
  2. Enteroscopy code
    By Colliemom in forum Gastroenterology
    Replies: 0
    Last Post: 04-01-2014, 09:33 AM
  3. Enteroscopy with tattoo
    By tpontillo in forum Gastroenterology
    Replies: 0
    Last Post: 11-29-2012, 01:51 PM
  4. Single Balloon Enteroscopy
    By Klynch49 in forum Gastroenterology
    Replies: 0
    Last Post: 09-14-2011, 11:14 AM
  5. Egd capsule enteroscopy - procedure code
    By sbarat in forum Outpatient Facilities
    Replies: 1
    Last Post: 07-20-2010, 11:37 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?


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.