Your gastroenterologist performed a video esophagogastroduodenoscopy (EGD) with small bowel enteroscopy, clipping and BICAP cautery as well as biopsies. The patient had a 2-mm bleeding arteriovenous malformation (AVM) in the fourth portion of the duodenum that the physician controlled by ablation with BICAP cautery and with a tri clip application. Also, the patient had a 1-mm AVM in the proximal jejunum that the gastroenterologist ablated with BICAP cautery.
Solution: Don’t fall into the trap of thinking this example should include multiple codes. Because the gastroenterologist used all of these modalities to accomplish one goal--basically the AVMs’ hemostasis/occlusion--you should use only one code (43255), says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA’s CPT Advisory Panel.
Excerpts from Gastroenterology Coding Alert