AHA Coding Clinic® for HCPCS - 2012 Issue 4; Ask the Editor

ERCP with Stomach Biopsy

A patient at our facility underwent an endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and biopsy of the stomach. According to the operative report a duodenoscope was passed through the esophagus and into the stomach where pathology is identified and a biopsy was taken. The scope was advanced into the duodenum where the bile duct was cannulated and the ERCP sphincterotomy was performed. We are concerned with assigning the appropriate code for the biopsy of the stomach as we are interpreting CPT code 43261, Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple, to involve a procedure on the hepatobiliary system and not the gastrointestinal system. Would CPT code 43239, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy or multiple, be a more appropriate code for the biopsy of the stomach performed? ...

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