Anna-Marie Posted Tue 20th of January, 2015 14:03:50 PM
A patient with stricture of the biliary duct has stent exchange performed because of stent blockage. Is it correct to code 43276 with 576.2 as the primary ICD9 code, and 996.59 as the second?
SuperCoder Answered Tue 20th of January, 2015 16:52:10 PM
Thanks for your question. 43276; Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged is the appropriate procedure code to use in this scenario. The diagnosis codes that you have selected appear to be correct as well; however, they may not be covered by the payer for this procedure code. You should check your LCD or payer policy to determine if these codes are covered. You may be able to also query your provider for more information to determine if another diagnosis code may be more applicable. Hope this helps.