Eleen Posted Mon 22nd of January, 2018 14:36:34 PM
Our Physician performed the following procedure, I need a little guidance please.
Endosonographic Finding.There was a large anechoic cyst with hypoechoic and hyperechoic debris within the lumen. A mature wall was visualized. Using a 19 G and then a 22 G needle, the cyst was accessed and fine needle aspiration was performed. Brown murky fluid was aspirated. Next, contrast was injected and visualized fluoroscopically confirmed access of the walled off pancreatic collection. Next, a 10 mm lumen-apposing stent with a 15 mm diameter was placed under endosonographic and endoscopic guidance using cautery to access the cyst (hot Axios cystgastrostomy stent placement). There was copious cyst contents visualized flowing through the stent. The scope was not advanced through the stent, but necrotic debris was visualized.
Impression:Pancreatic necrosis / walled off collection s/p cystgastrostomy using a 15
mm diameter lumen-apposing stent under endosonographic guidance. Replacement of Dobhoff tube with bridle.
SuperCoder Answered Tue 23rd of January, 2018 05:52:02 AM
As per above scenario, CPT code 43240 for cystgastrostomy stent placement (fine needle aspiration would be included in this CPT and will not be coded separtely) would be the appropriate CPT. Second CPT would be 43752 for replacement of Dobhoff tube with bridle.
HOPE THIS HELPS!