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.
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