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Susan Posted Thu 12th of September, 2013 16:38:01 PM

43239/59 and 43242: Endoscope passed to sec ond part of duodenum with a biopsy of gastric polyp found(211.1) then an Endoscopic ultrasound with FNA on a cyst/pseudocyst FNA. I am inclined to bill 43242 with 577.2 then 43239/59 with 211.1, Rational is two seperate sites, two seperate techniques. Can you please advise if this would be the appropriate way to code.

SuperCoder Answered Thu 12th of September, 2013 19:55:17 PM

I agree with you.

If your gastroenterologist uses the endoscope (with EUS) beyond the esophagus for biopsy, then you need to switch to other codes. "When a physician uses an upper endoscope to complete a fine needle aspiration beyond the esophagus, 43242 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy[s] [includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum and/or jejunum as appropriate]) is assigned,". "This procedure may be used to aspirate or biopsy a mass that may be suspicious for malignancy in the stomach, duodenum, and/or jejunum. This procedure is commonly used to aspirate/biopsy pancreatic pseudocysts." If you see this in your procedure notes, you can report it with 43242.

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