tci General Surgery Coding Alert - 2015 Issue 12

Reader Question: Select Modifier for Incomplete ERCP

Question: During an ERCP procedure, the surgeon made numerous failed attempts with the catheter tip and guidewire. Then he used the standard Hydratome, but over the course of an hour, the physician did not perform a single direct cannulation of either the common bile duct or pancreatic duct, nor did he insert the wire or contrast. How should I code this?  SuperCoder Subscriber Answer: You should report 43260 (Endoscopic retrograde cholangiopancreatography [ERCP]; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]) with an appropriate modifier. You have two modifiers that you could append to...

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