Health Information Management

Tip: Bundling added to endoscopy stent placements

APCs Insider, March 6, 2014

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The AMA added additional bundled codes that involve stent placements during endoscopies to the 2014 CPT® Manual. It deleted codes 43219, 43256, and 43268, and replaced them with new codes that now include pre- and post-dilation and guidewire passage. Those codes are:
  • 43212, esophagoscopy, flexible, transoral, with placement of stent
  • 43266, EGD, with placement of stent
  • 43274, ERCP, with placement of stent, includes sphincterotomy
Coders should make another note in their manuals for the revised codes that involve dilation for esophagoscopy and EGD. The revised codes read:
  • 43220, esophagoscopy, with transendoscopic balloon dilation (less than 30 mm diameter)
  • 43249, EGD, with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)
For dilations of 30 mm or larger, coders should use 43214 (esophagoscopy) or 43233 (EGD), though these high-risk procedures are commonly used with a diagnosis of achalasia.
This tip is adapted from “Parenthetical note changes dominate 2014 CPT updates” in the February issue of Briefings on APCs.

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