Quantcast
Channel: Supercoder - Ask an Expert? Forum: Gastroenterology Coding - Recent Posts
Viewing all 1013 articles
Browse latest View live

SuperCoder on "Fecal bacteriotherapy instillation 44705"

$
0
0

The procedure involves destroying unhealthy bacteria in a patient's gut and then replacing the existing gut bacteria with new healthy gut bacteria isolated from another person (donor). This new procedure is now frequently being used to combat virulent strains of Clostridium difficile infections not responding to antibiotics or other forms of treatment. Fecal Microbiota can be transplanted by several routes like via colonoscopy, EGD, NG feeding tube or via rectal enema. Under anesthesia, the physician inserts a scope into the mouth (or other routes, as preferred) which is passed (or is attempted to pass) through the pylorus (pyloric sphincter) into the duodenum and/or jejunum. It helps gut microorganisms to repair or replace the disrupted native microbiota. This procedure also includes the assessment of donor specimen where the donor is tested for bacterial and parasitic infections. The fecal transplant material is then prepared and administered in a clinical environment to ensure that precautions are taken. It is given in constipation, irritable bowel syndrome and inflammatory bowel disease.

If your gastroenterologist performs a stool transplant, you will report part of this service with 44705 (Preparation of fecal microbiota for instillation, including assessment of donor specimen).

In addition to the preparation of the donor specimen (reported using 44705), you will have to use the appropriate code for the instillation of the specimen in the gut. Depending on choice, your gastroenterologist might perform a colonoscopy, EGD, rectal enema or a nasogastric tube to instill the specimen. For example, if your gastroenterologist uses an EGD to instill the specimen, you should report 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) along with 44705 for the preparation of the specimen.

Example: Your gastroenterologist decides to perform stool transplant on a patient suffering from C. difficile infection not responding to antibiotic treatment and other forms of treatment. He decides to use a sample from the patient's spouse for the transplant. He orders a thorough assessment of the stool sample to check for communicable diseases and other parasitic infections. He then prepares a sample for instilling in the patient's gut.

Your gastroenterologist then performs a colonoscopy to instill the stool sample. You will report the services using 44705 for the preparation and assessment of the stool sample and 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) for the colonoscopy he performed to place the stool sample in the patient's gut.


SuperCoder on "Fecal biotherapy through J Tube"

$
0
0

44705 will only cover the preparation of the specimen to be used for fecal bacteriotherapy. There is no specific code for instillation of the specimen through the J-tube. This part of the procedure will have to be reported using 44799.

User id : 30470 on "Endoscopy to jejunum and removal of remnant gastric poly w/snare"

$
0
0

Hello,
How would you code endoscopy to the jejunum and removal of a remnant polyp in the stomach? The pt had a EGD 10 days prior for GI bleed. A polyp from stomach was partially removed. Now came back for endoscopy to the jejunum to further investigate GI bleed and the dr removed the rest of the polyp in the stomach.

Thank you for your help!

SuperCoder on "Billing pathology with multiple units"

$
0
0

We apologize for the delay.My editor is working on this. She will get back very soon. Thanks for being patient.

SuperCoder on "Endoscopy to jejunum and removal of remnant gastric poly w/snare"

$
0
0

Since only partial removal of polyp was there and the rest of the polyp is removed as per planned procedure in global period. Use 43239-58.

SuperCoder on "Billing pathology with multiple units"

$
0
0

As per CPT guidelines:

"The unit of service for codes 88300 through 88309 is the specimen."

As per CPT Assistant Dec 2011:

"In addition, the unit of service for codes 88300-88309 refers to the specimen. Therefore, if the gallbladder material received for pathologic examination comprising multiple specimens for individual and separate attention and individual examination and pathologic diagnosis, each specimen’s gross and microscopic examination performed is considered a single unit of service. The appropriate surgical pathology code should be reported. Codes 88300-88309 do not include the services described by codes 88311-88388."

Therefore no published MUE value for the code 88305 is available. Was there any particular reason for denial?

User id : 25339 on "Stool Transplant on a Medicare Patient"

$
0
0

My physician is doing the stool transplant procedure. We are being told by a hospital consultant that when he does a stool transplant on a Medicare patient he can only charge the 'G0455'. My physician is instilling the stool via the colonoscopy method. He is going all the way to the cecum; however, we are being told the only code we can charge for the Medicare patient is'G0455'. We are in the state of North Carolina. We have Palmetto Medicare as our carrier.

Vickie Terry

SuperCoder on "Stool Transplant on a Medicare Patient"

$
0
0

In CPT 44705 (Preparation of fecal microbiota for instillation, including assessment of donor specimen) is a new gastroenterology procedure for Stool Transplant but CMS does not accept RUC (Relative Value Scale Update Committee) recommended RVU and has created HCPCS Code G0455 for this procedure. Concern is Medicare payment for the preparation of the donor specimen would only be made if the specimen is ultimately used for the treatment of a beneficiary.To bill for CPT code 44705 please use HCPCS code G0455 (Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen).


User id : 22449 on "Food Bolus"

$
0
0

In need of a diagnosis code for food bolus

SuperCoder on "Food Bolus"

$
0
0

Consider the appropriate foreign body code, such as 935.1 (Foreign body in esophagus)

User id : 49140 on "total proctocolectomy"

$
0
0

How should a "colonscopy" be coded on a patient who has had a Total proctocolectomy with ileoanal pull through? The performing physician calls it a colonoscopy on the operative report and a pouchoscopy on the schedule. The original ordering physician placed the order for a sigmoidoscopy. See op report:

Procedure: Colonoscopy

The Colonoscope was introduced through the anus and advanced to the terminal ileum.

Findings:

J pouch with normal appearing small bowel anastomosis of small bowel and anus about 10 mm with small fistula opening. The terminal ileum appeared normal.

Thanks!

SuperCoder on "total proctocolectomy"

$
0
0

This is 44385-During pouchoscopy, the GI physician introduces the scope into the rectum to visualize an ileoanal J pouch in the area of the small intestine. The appropriate code for this is 44385 (Endoscopic evaluation of small intestinal [abdominal or pelvic] pouch; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]).

User id : 25755 on "ERCP w/stent exchange?"

$
0
0

ERCP preformed to remove the oringinal stent that is a 7 French and replace it with a 10 French x 9cm decompression of the biliary tree in standard fashion.

No biopsies or other procedure performed.

User id : 25755 on "ERCP w/stent exchange?"

User id : 49140 on "EGD code"

$
0
0

I am unsure of the CPT code for the following:

The indications are: Patient with central pancreatectomy complicated by anastomotic leak. EGD to evaluate the gastric anastomotic are.

Procedure:
Endoscope was introduced through the mouth, and advanced to the second part of the duodenum
In the stomach, the G-J tube was present with the J tube coiled in the stomach. Duodenum was normal with the tube from pancreatic duct in place. The jejunal limb was grabbed with clip and advanced into the jejunum. (During this process clip got dislodged in the stomach, it was not deployed on any wall.)

What do you thing the CPT code should be? How about dx code?


SuperCoder on "ERCP w/stent exchange?"

$
0
0

In your scenario, it sounds as if the stent was already in place when the procedure began, so you would be safe to use 43269. Considering the definition of the code, many gastroenterologists feel this most aptly describes the procedure. If the gastroenterologist placed the stent during the procedure, it would be correct to bill 43268 even if he removed the stent at the end of the procedure.

The National Correct Coding Initiative (NCCI) lists the stent placement and removal codes as mutually exclusive, which means they cannot be "reasonably done in the same session." Traditionally, gastroenterology practices have not billed separately for the stent placement when done in combination with stent removal because of this edit.

Some practices have billed only 43268 (Endoscopic retrograde cholangiopancreatography [ERCP]; with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct) because the introduction to NCCI says to bill the lower-valued procedure in a mutually exclusive edit. Other practices have reported 43269 (... with endoscopic retrograde removal of foreign body and/or change of tube or stent) because it was the higher-valued procedure.

More recently, some practices began billing both the stent placement and removal because the edit contains an indicator of "1", which means a modifier can be used to override the edit and differentiate between the services provided. However, this only allows for gastroenterol-ogists to receive reimbursement for stents placed and removed in different ducts and is not intended in situations when the physician removes and replaces a stent in the same duct.

You cannot code for the cholangiogram, which is a form of visualization in which contrast material is injected into the bile ducts to see if there are any stones present after an extraction. This, along with other types of visualization techniques, is an integral part of an ERCP and is not separately billable.

SuperCoder on "EGD code"

$
0
0

I do not see anything being performed here. Simple EGD done to check gastric anastomotic area.

43235-537.89

User id : 49140 on "Liver biopsy specimen not obtained"

$
0
0

Hello,

What cpt code do you use if a liver biopsy was performed, but no specimen was obtained?

The operative report reads "No tissue was obtained. Two passes 16 gauge in diameter were made with the Klastskin needle using ultrasound to mark the site. No biopsies or other specimens were collected for this exam."

There is no reason given as to why a specimen was not obtained.

Thanks!

SuperCoder on "Liver biopsy specimen not obtained"

$
0
0

Code 47000, Biopsy of liver, needle; percutaneous, is the surgical code for a core liver biopsy (with any size needle) performed as a separate procedure. If a liver biopsy is performed as part of another operative procedure, then code 47001 should be reported. Modality specific needle guidance placement code 76942, Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation, is reported for the ultrasonic guidance.

Use 47000-52 for this case.

User id : 49140 on "Esophageal dilation"

$
0
0

I am unclear on the different types of dilators available for esophageal dilation. What CPT code would you use for the following:

"Scope passed up to middle esophagus, know stricture seen. Wire confirmed in the stomach and CRE balloon used to dilate up to 9mm."

Since a guide wire was used, would you use 43226

Or, since a balloon was used, would you use 43220?

Thanks for you help!

Viewing all 1013 articles
Browse latest View live