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Which CPT code

Sandeep Posted Thu 13th of February, 2020 05:29:19 AM
Procedure/Operation 1-EGD with Zenker's diverticulectomy Procedure indication: 1-dysphagia. 2-Zenker's diverticulum. Procedure Findings 1-2 cm Zenker's diverticulum. 2- normal esophagus. 3-normal stomach 4-normal duodenum. Endoscopic therapy: The endoscope was placed in the stomach. 0.035 inch guidewire was advanced into the gastric antrum. The esophagus and stomach was then irrigated with 500 cc of saline mixed with gentamicin solution. The endoscope was withdrawn only. 18. French NG tube was then advanced over the guidewire and placed in the stomach. And I would be a T-type hyper knife was then used. A small incision was made in the midcricopharyngeal bar. Submucosal injection was then followed by injecting saline mixed with methylene blue. The submucosa was then dissected. The scope was advanced into the tunnel. Dissection was performed in the submucosa anterior to the cricopharyngeal bar and from the back. Endoscopic myotomy was then performed by cutting the muscle layer. A total of 4 endoclips were placed to close the mucosectomy. Please suggest CPT codes
SuperCoder Answered Fri 14th of February, 2020 02:07:39 AM

Hi Sandeep,

 

Thanks for your question.

 

As per the documentation, the patient did have a muscle diverticulum (Zenker's diverticulum) and the provider did remove this endoscopically. Hence the correct code should be 43180 (Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed).

 

Please feel free to write if you have any question.

 

Thanks

Sandeep Posted Fri 14th of February, 2020 04:23:45 AM
If the Zenker's diverticulum is treated when only esophagoscopy is performed, which CPT code should be reported? and if the f the Zenker's diverticulum is treated when complete EGD is performed, which CPT code should be reported?
SuperCoder Answered Mon 17th of February, 2020 02:32:44 AM

If the Zenker's diverticulum is treated when only esophagoscopy is performed, CPT code 43180 (Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed) should be reported.

 

If the f the Zenker's diverticulum is treated when complete EGD is performed, then CPT codes 43235 - 43210 (depending upon documentation) may be reported.

 

Hope this helps.

 

Thanks

Sandeep Posted Mon 17th of February, 2020 06:36:50 AM
Please specify which code from EGD section will be reported?
SuperCoder Answered Tue 18th of February, 2020 06:04:47 AM

Choosing a particular code depends upon your documentation. When EGD is performed, and at the same time, diverticulum from esophagus is removed, then only EGD should be reported.

 
Hope this helps.
 
 
Thanks.

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