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Gastroenterology Coding Alert

Endoscopic Retrograde Cholangiopancreatography: 43262-43269 Is Your Guide to Profitable ERCP Coding


- Published on Thu, Nov 18, 2010

Get paid twice the $440 rate for 43268. Find out how.

If you think coding for endoscopic retrograde cholangiopancreatography (ERCP) is a simple one-code affair, you're mistaken. If your gastroenterologist performs a sphincterotomy, gallstone lithotripsy, stent placement, or a fluoroscopy, you can mix and match the different ERCP CPTs without any consequences -- except, perhaps, a much welcome added dollars to your reimbursement.

Read through the following 3 frequently asked questions and get no-nonsense advice straight from the experts.

FAQ 1: Should I Mind 43268, 43262 Bundles?

When your gastroenterologist performs a pancreatic stent placement during an ERCP with sphincterotomy, you can bill for two CPTs on your claim: 43268 (Endoscopic retrograde cholangiopancreatography; with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct) in addition to 43262 (Endoscopic retrograde cholangiopancreatography; with sphincterotomy/papillotomy).

And you don't have to worry about using any modifier as no such is required, according to Jennifer Lawrence, CPC, [...]

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