tci General Surgery Coding Alert - 2020 Issue Q2

You Be the Coder: Watch NCCI Edits for EGD Case

Question: Our surgeon performed an EGD with lesion ablation. The op note also documents that the surgeon needed to use a plasma coagulator to control extensive bleeding that occurred following the ablation. Can we separately bill the ablation and bleeding control? Kansas Subscriber Answer: No, you should not bill both 43270 (Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)) and 43255 (… with control of bleeding, any method) for this case. You should claim only the 43270 service. Here’s why: The National Correct Coding Initiative...

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