tci General Surgery Coding Alert - 2024 Issue Q1

Reader Questions: Collecting Payment for Complications During Surgery

Question: One of our general surgeons encountered some challenges while attempting to perform a banding procedure for esophageal varices. The surgeon unintentionally induced active variceal bleeding during the procedure. The surgeon then carried out sclerotherapy to manage the bleeding. The dilemma now is whether to document the banding procedure, the sclerotherapy, or both? AAPC Forum Participant Answer: You should report 43244 (Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices) with modifier 53 (Discontinued procedure). You should get some reimbursement for the service, but the amount will probably vary from payer to payer. “Remember that modifier 53 may...

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