Gastroenterology is a medical specialty that deals with its ailments and the digestion. Gastroenterologists utilize numerous diagnostic procedures prescribe treatment and to identify the individual’s health condition. Coding for gastroenterology entails accurate coding of services and the processes. Reimbursement is offered for processes supplied in ASC facility configurations and facility, hospital outpatient. Payment policies differ with individual payers and for that reason these should be confirmed before providing treatment to identify constraints if any, on identification, site of coding or service requirements. Common Gastroenterology Techniques – ERCP – this process combines the use of endoscope and X rays. These assist the doctor to view the interior of the GI tract including the esophagus, stomach along with duodenum.
When billing for Upper GI processes, for masking the procedure you have to verify payer conditions. The services are covered when ailments like anemia, disease, gastric ulcer disease, persistent stomach outward symptoms, and weight reduction are diagnosed.
- 4320 Diagnostic esophagoscopy
- 4320 2 Esophagoscopy with biopsy
- 4321 5 Esophagoscopy with foreign body removal
- 4321 6 Esophagoscopy with electrocautery elimination of tumor or polyp
- 4321 7 Esophagoscopy with snare elimination of tumor or polyp 4322 Esophagoscopy with dilation
- 4322 7 Esophagoscopy with control of bleeding
- 4323 2 Esophagoscopy, rigid or flexible, with transendoscopic ultrasound guided or transmural fine needle aspiration/biopsy
- 4323 4 EGD – simple primary examination
- 4323 5 EGD – diagnostic
- 4323 8 Upper gastrointestinal endoscopy with transendoscopic ultrasound guided or transmural fine needle aspiration/biopsy esophagus –
- 4323 9 EGD with biopsy
- 4324 1 EGD with transendoscopic catheter or tube positioning
- 4324 2 Upper gastrointestinal endoscopy with transendoscopic ultrasound guided or transmural fine needle aspiration/biopsy
- 4324 6 EGD with PEG tube placement
- 4324 7 EGD with foreign body removal
- 4325 EGD with electrocautery elimination of tumor or polyp – 4325 1 EGD with snare elimination of tumor or polyp
4325 5 EGD with management of bleeding – Certain codes 4320 0, 4320 2, 4323 4, 4323 5 and 4323 9 require prior authorization with a few payers, and this has to be confirmed ahead.
Some Important Considerations – A comprehensive endoscopic in evaluating the upper GI tract needs to be reported using the code 4323 5. This usually entails a detailed observe of the esophagus, stomach along with duodenum along with a thorough evaluation of the duodenal bulb. Physicians should use code 4323 9 to report EGD with biopsy. An EGD that’s provided just as a primary evaluation and doesn’t include understandable components can be reported using the code 4323 4.