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Removal of Biliary Stent via Gastroscopy


Question

A patient comes in to have a biliary stent removed post cholecystectomy.  The stent was removed via a gastroscope.  What CPT code would be used?

Answer

Use 43247. See Coding Clinic for HCPCS, 2nd quarter 2008, page 6:

QUESTION 6 - A 24-year-old patient with sphincter of Oddi dysfunction presents for removal of a biliary stent via an EGD. A videoendoscope is inserted into the oral cavity and multiple biopsies were taken from the proximal stomach. The biliary stent was located in the second portion of the duodenum in the ampulla, where it was removed by snare device. How should this procedure be reported?

ANSWER - Report CPT code 43239, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple, for the EGD with biopsies of the stomach.
 
According to the CPT codebook, in the index under Removal, stent, bile duct or pancreatic duct, the coder is guided to CPT code 43269, Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of foreign body and/or change of tube or stent.
 
Therefore, when supported by physician documentation CPT code 43269 would be reported for the removal of a biliary or pancreatic stent if an ERCP is performed. If an ERCP is not performed CPT code 43247, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and /or jejunum as appropriate, with removal of foreign body, would be reported for the removal of the biliary or pancreatic stent. Otherwise query the physician for clarification when the documentation is unclear.

Disclaimer: All articles intended for general guidance only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.

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