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ERCP with Plastic Stent vs Metal Stent

Federico Posted Mon 20th of October, 2014 11:38:54 AM

There is a big diffence between placing a plastic stent versus a metal stent during an ERCP session. Is there a way to bill for this difference other than modifier 22??

SuperCoder Answered Mon 20th of October, 2014 22:46:56 PM

Thanks for your question. The procedure code 43274; Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent does not differentiate by type of stent. You would use this code for a stent of any material. Modifier 22 would be the best way to try to get additional reimbursement for the use of a metal stent.

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