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EGD BiCAP coag

Thomas Posted Wed 19th of September, 2012 21:42:42 PM

What CPT code(s) would be used to file insurance for an EGD with injection therapy and BiCAP coag of a bleeding lesion and biopsies.
If more than one CPT used what order would the first CPT code be listed and does the second CPT need a modifier. Thank you. Oklahoma Subscriber

SuperCoder Answered Thu 20th of September, 2012 13:53:16 PM

Your gastroenterologist performed a video esophagogastroduodenoscopy (EGD) with small bowel enteroscopy, clipping and BICAP cautery as well as biopsies. The patient had a 2-mm bleeding arteriovenous malformation (AVM) in the fourth portion of the duodenum that the physician controlled by ablation with BICAP cautery and with a tri clip application. Also, the patient had a 1-mm AVM in the proximal jejunum that the gastroenterologist ablated with BICAP cautery.

Solution: Don’t fall into the trap of thinking this example should include multiple codes. Because the gastroenterologist used all of these modalities to accomplish one goal--basically the AVMs’ hemostasis/occlusion--you should use only one code (43255), says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA’s CPT Advisory Panel.

Excerpts from Gastroenterology Coding Alert

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