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43756 for small bowel aspiration during EGD/enteroscopy

Amy Posted Fri 23rd of May, 2014 16:45:21 PM

Our provider does an aspiration of SB fluid to culture for bacterial overgrowth. During the EGD or enteroscopy, he threads a separate catheter and collection system through the scope to obtain the sample for culture.
Our provider went to a conference where this was discussed and he was intructed to bill 43756 in addition to the EGD or enteroscopy.
To me, the definition of this code doesn't fit exactly what the provider is doing, and no image guidance is used, either.
Plus, 43756 is bundled into the EGD family, but not the enteroscopy family.
Can you shed any light on this?

SuperCoder Answered Mon 26th of May, 2014 17:04:20 PM

From my CE's Desk :

"Fluid collection during EGD is included in the procedure. Code 43756 is used when a fluid collection is done by placing a catheter WITHOUT an endoscope. If someone gave him advice otherwise I would like to know who and if that is in writing. He might need it when the carriers or the government accuse him of fraud."

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