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Gastroenterology Coding Alert

Bleed Control:

43255 Leaves No Stones Unturned for Control-of-Bleeding Situations

Forget about modifier 22 or you'll be stuck in old school.Modifier 22 may not be the ally you're looking for when coding for excessive blood loss. The answer may lie on more appropriate CPTs such as 43255 and critical care codes. Learn from these two scenarios.Consider Endoscopy-With-Injection as OptionScenario 1: The doctor injects epinephrine into a duodenal ulcer to control active bleeding during endoscopy with biopsy (43239, Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple).Code it: In the past, you may opt to use 43239 appended with modifier 22 (Increased procedural services) if the physician required significant effort to control the patient's bleeding.This option, however, would require you to submit additional paper documentation to support your modifier 22 claim.Instead of submitting yourself to potential hassles, you can accurately describe this session by reporting 43239 for the biopsy and 43255 [...]

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