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Endoscopy procedures constitute an important part of diagnostic and therapeutic interventions related to the digestive system of patients. The administration of different types of endoscopy depends on the symptoms experienced by the patient and the particularities of the condition. In particular, several customary types of endoscopy exist, including endoscopic retrograde cholangiopancreatography, esophagogastroduodenoscopy, endoscopic ultrasound, colonoscopy, and sigmoidoscopy (American Medical Association, 2020). An example of an endoscopy procedure might be endoscopic retrograde cholangiopancreatography, a diagnostic intervention that might be performed for a patient with the signs of pancreatic cancer. The symptoms of this condition might include yellowing of eyes and skin, stomach ache, nausea, and sudden weight loss. In such a case, a patient should be appointed to endoscopic retrograde cholangiopancreatography for diagnosis and specimen collection for further examination.
An important stage of the procedure performed is the coding. The CPT code applicable for the guidelines and symptoms is 43260. It refers to endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen (American Medical Association, 2020, p. 3). The selection of this CPT code should be based on the verification of the symptoms with the physician to clarify the necessity of the procedure for a given patient. In particular, a physician should examine blood tests to identify any indication of changes related to liver functioning. In addition, the medications and allergies should be established, and proper actions are taken to adjust them in order to ensure that the procedure is safely executed. Thus, adequate and valid procedure coding predetermines verification and clear establishment of patient current state, symptoms, and blood test results.
Antepartum and postpartum coding include the coding of procedures and services provided to a patient before and after the delivery. Commonly, the billing of procedures administered to patients throughout their pregnancy is conducted according to codes of global maternity services ( Obstetrics coding and documentation reference guide, 2020). In such a case, all the services, including antepartum, delivery, and postpartum procedures, are executed by the same provider. However, there are cases when antepartum and postpartum procedures should be billed separately, which is why specific coding outside the global maternity service coding should be applied. In particular, such cases include instances when pregnancy started before the coverage was initiated, when coverage ends before delivery, or when global services cannot be completed due to relocation of the patient ( Obstetrics coding and documentation reference guide, 2020). In such cases, the claims are submitted separately and not within the global maternity services.
Two codes apply to a scenario when a patient obtains only antepartum or postpartum services while the delivery claim is billed separately. The first code that applies to the scenario is 59430 postpartum care only (separate procedure) ( Obstetrics coding and documentation reference guide, 2020, p. 2). Secondly, assuming that the patient had seven visits, the applicable code is 59426 antepartum care only; 7 or more visits ( Obstetrics coding and documentation reference guide, 2020, p. 2). The services that are provided antepartum and should be billed separately are multiple. Some examples of them might be diagnostic ultrasounds, which are performed, amniocentesis, chorionic villus samplings, fetal stress tests and fetal non-stress tests ( Obstetrics coding and documentation reference guide, 2020, p. 3). These procedures are excluded from the global maternity services and should be billed within antepartum services separately. Thus, the coding of services obtained by the patient before and after the delivery but not including the delivery itself should be conducted with accuracy given the context and the number of visits.
References
American Medical Association. (2020). 2021 GI endoscopy coding and reimbursement guide. Web.
Obstetrics coding and documentation reference guide. (2020). Web.
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