CPT 43450

Reporting Failed Esophageal Dilation Followed By An Endoscopy

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 43450 – CPT 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.

Similar Posts

Leave a Reply

Your email address will not be published.