Tag: CPT

09 Apr 2016

How to code for optical endomicroscopy? (an optical biopsy)

blog_opticalendomicroscopy

What is it?

This technique involves use of optical technology to see enlarged view of cell, tissues in real time. It is also called Optical Biopsy. The doctor uses a probe, which is used to view the cellular structures in the organ concerned. It is found to be useful in:

  1. Barrette’s esophagus in detecting dysplastic lesions.
  2. In early detection of gastric cancer and intestinal metaplasia.
  3. Detection of malignant bilio-pancreatic strictures.
  4. Diagnosis of pancreatic cysts.
  5. Inflammatory bowel disease.
  6. Helps to differentiate between neoplastic and non neoplastic tissue.
  7. Detecting residual neoplasia after concerned tissue removal.

Coding

The year 2013 saw the allocation of two CPT codes: 

43206 – Esophagoscopy with optical endomicroscopy.

43252 – EGD with optical endomicroscopy.

These procedures cannot be reported with other endoscopy procedures. They are reported as separate and distinct procedures.

Payment 

43206 and 43252 attracted an average payment of $149 & $186 respectively in a facility setting.