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45320 verses 45334

Joseph Posted Mon 20th of February, 2012 22:13:00 PM

My first question is the doctor's note states indication for procedure is radiation proctitis. Does anyone know the correct code for this? I am using 569.49 but can't find a more specific code.

My second question is the same note states the patient is having a Barrx Halo Ablation. I am told to use cpt code 45334 which is for control of bleeding. The note states an ablation electrode was used to ablat the area. The note states that there was evidence of past bleeding but does not state if area was bleeding at time of procedure. Which code is appropriate the 45320 or 45334? Thanks for any insight on this issue.

SuperCoder Answered Tue 21st of February, 2012 08:54:23 AM

Hi Joseph,

For your first query, there are several options, including 569.49 (proctitis NOS) and 556.2 (ulcerative proctitis) plus code 909.2 (late effect of radiation). Code 558.1 (radiation entercolitis) is another possibility. You should work with the physician to select the code that is most accurate for the patient's condition. However, we have an option. If the indication of procedure is truely radiation proctitis in the document, then you definitely go for 569.49 because I checked in ICD-10 CM K62.7 (Radiation proctitis) crosswalk and it is saying (one-to-one)ICD-9 code 569.49.
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For your second query, as there was evidence of past bleeding, but does not state the area was bleeding at time of procedure, I would prefer to go for 45320. There is no code for BARRX Halo ablation. BARRX Halo ablation is a radiofrequency device approved by FDA to be used in the coagulation of bleeding and non-bleeding sites in the gastrointestinal tract. The HALO360 Ablation Catheter ablates ~3 cm long all the way around the esophagus (circumferentially 360 degrees). For patients with Barrett's esophagus lesions longer than 3 centimeters, the HALO360 Ablation Catheter is simply repositioned and the ablation steps are repeated.
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Again I will research on this and come up with clearance if I will be getting any finding.

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