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New E&M codes for the year 2019

For 2019, the E&M section of CPT code book will have two new codes for Interprofessional Telephone/Internet/Electronic Health Record...

Can we report both failed esophageal dilation followed by an endoscopic esophageal dilation?


According to NCCI policy manual if a procedure utilizing one approach fails and is converted to a procedure utilizing a different approach, only the completed procedure may be reported. Hence If esophageal dilation as described by CPT codes 43450 - 43458 fails and is followed by an endoscopic esophageal dilation procedure, only the endoscopic esophageal dilation procedure may be reported.  The physician should not report the failed procedure.

Another example: If an endoscopic procedure fails and is converted into an open procedure at the same patient encounter, only the open procedure is reportable.  Neither a surgical endoscopy nor diagnostic endoscopy procedure code should be reported with the open procedure code when an endoscopic procedure is converted to an open procedure.

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