Learn about Colonoscopy and Endoscopy billing procedure methodologies. GI gastrointestinal endoscopy and colonoscopy preparation, complication and what happened after the process. How to do the correct billing. EGD, GI and Screening CPT codes. CPT codes 43235-43259 have been placed in the new EGD subsection. These codes have been revised to describe flexible transoral EGD and include five new codes, revision and renumbering of several existing codes and the deletion of two codes.
Upper intestinal endoscopy is performed with a lighted, flexible, fiberoptic instrument passed through the cricopharynx. A topical anesthetic is sometimes applied to the posterior pharynx. Diagnostic observations are made concerning focal benign or malignant lesions, diffuse mucosal changes, luminal obstruction, motility, and extrinsic compression by contiguous structures. Gastrointestinal bleeding may be treated with a variety of methods. Direct contact heater probes and hemostatic injections into or around the bleeding vessels are both effective therapy for acute bleeding. Foreign body removal from the stomach or esophagus is usually successful with these flexible instruments. The foreign bodies can be retrieved by either of two methods. The second method is accomplished by piecemeal destruction and pushing the bolus through the esophagus into the stomach.
Esophageal varices may be injected with a variety of sclerosing solutions. Eradication of varices requires, on the average, five sclerotherapy sessions, with multiple injections given during each session. Dilatation of strictures may be accomplished with a balloon placed through the endoscope and inflated using hydrostatic pressure. Bougies are rubber dilators available in various sizes up to approximately 2. Plastic bougies and other dilating probes are usually passed over a guide wire. This procedure involves placing the guide wire into the stomach through the endoscope. The endoscope is then withdrawn leaving the guide wire in place. Biopsy surveillance of patients with Barrett’s esophagus every 12 to 24 months.
Cancer surveillance in patients with pernicious anemia, treated achalasia, or prior gastric resection. EGD is generally contraindicated for patients with recent myocardial infarction. The EGD family includes a code for insertion of guide wire followed by dilation over guide wire. 43237 and 43238 have been revised to describe EUS limited to the esophagus, stomach or duodenum and adjacent structures. Endoscopic ultrasound codes 43242 and 43259 have been revised to include examination of a surgically altered stomach where the jejunum is examined distal to the anastomosis. Dilation procedure codes have been added, revised and deleted to better describe current practice. EGD code 43249 has been revised to specify transendoscopic balloon dilation of less than 30 mm in diameter. The parentheticals for code 43255, EGD with control of bleeding code 43255 have been revised. Code 43236, submucosal injection, would also not be reported if injection was part of the control of bleeding procedure.
30 mm in diameter or larger. This dilation procedure includes fluoroscopic guidance, when used. The key to accurately coding endoscopic procedures depends on knowing exactly what the surgeon did and the final destination of the scope. QUESTION: Is there a difference regarding the use of modifiers 52 and 53 with regards to upper and lower endoscopic procedures? 52, if repeat examination is not planned, or modifier 53, if repeat examination is planned. Example: EGD is performed and a tube is placed into the stomach.
The duodenum is not examined and there is no plan to perform repeat EGD to examine the duodenum. Plan to control bleeding, lavage stomach and repeat upper endoscopy. There are unusual exceptions in which colonoscopy may be done once to rule out organic disease. Uncomplicated heartburn responding to medical therapy. Metastatic adenocarcinoma of unknown primary site when the results will not alter management. Asymptomatic or uncomplicated sliding hiatus hernia. Uncomplicated duodenal bulb ulcer that has responded to therapy.
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During colonoscopy can hemorrhoids removed are a persistent condition — to the procedures available at the Southwest Endoscopy Center.