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NOTES: trans-lumenal, endoscopic pancreatic necrosectomy

Eleen Posted Tue 20th of September, 2016 08:12:52 AM
I need help with CPT. flexible endoscope was passed through the mouth under direct vision. The Endosonoscope was introduced through the mouth, and advanced to the antrum of the stomach. An anechoic lesion suggestive of a pseudocyst was identified adjacent to the pancreatic body. There was internal debris within the fluid-filled cavity. After a suitable location for cyst-gastrostomy was identified, the electrocautery enhanced Axios system was advanced through the stomach wall and into the cystic cavity under ultrasound guidance through an avascular pathway. The fully covered, lumen opposing metal stent (Axios) was then deployed creating a cyst-gastrostomy tract. The stent lumen was then dilated using a 12-15mm balloon dilator to 15mm under fluoroscopic guidance. The cavity was then endoscopically explored. Then entire cavity was filled with solid necrosis. Almost all of the solid necrosis was then removed using a combination of lavage and suction and spiral snare.
SuperCoder Answered Wed 21st of September, 2016 05:53:42 AM

As per documentation the appropriate CPT codes are 43251 and 76975.

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