Supplementary Material Appendix A. Gastrointestinal Tests ...

Supplementary Material

Appendix A. Gastrointestinal Tests and Procedures

Procedure

Code Type

Gastrointestinal Scope

ICD-9 Procedure

CPT

CPT CPT CPT Anoscopy CPT

CPT CPT

CPT

CPT

ICD-9 Procedure

CPT

CPT Colonoscopy CPT

CPT

CPT

CPT CPT

Code Description

49.21 anoscopy

46600

anoscopy; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)

46604 anoscopy; with dilation (eg, balloon, guide wire, bougie)

46606 anoscopy; with biopsy, single or multiple

46608 anoscopy; with biopsy, single or multiple

46610

anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery

46611 anoscopy; with removal of single tumor, polyp, or other lesion by snare technique

46612 anoscopy; with removal of single tumor, polyp, or other lesion by snare technique

46614 46615

anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

45.23 colonoscopy

45378

45379 45380 45381 45382

45383 45384

colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) colonoscopy, flexible, proximal to splenic flexure; with removal of foreign body

colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple

colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), any substance colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot

Small Intestinal Endoscopy

CPT CPT CPT CPT CPT HCPCS HCPCS HCPCS ICD-9 Procedure CPT CPT CPT CPT CPT CPT

CPT

CPT CPT CPT CPT

biopsy forceps or bipolar cautery

45385

colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

45386 colonoscopy, flexible, proximal to splenic flexure; with dilation by balloon, 1 or more strictures

45387 colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)

45391 colonoscopy, flexible, proximal to splenic flexure; with endoscopic ultrasound examination

45392

colonoscopy, flexible, proximal to splenic flexure; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)

G0105 colorectal cancer screening; colonoscopy on individual at high risk

G0121 colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

G0120 colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.

45.1X diagnostic procedures on small intestine

44360 44361 44363 44364 44365 44366

44369

44370 44372 44373 44376

small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)

Upper GI Endoscopy

CPT

CPT

CPT

CPT

CPT ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure CPT CPT

CPT

CPT

CPT

CPT

CPT

CPT

CPT

44377 44378 44379 44385 44386

small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation) endoscopic evaluation of small intestinal [abdominal or pelvic] pouch; diagnostic, with or without collection of specimen[s] by brushing or washing

endoscopic evaluation of small intestinal [abdominal or pelvic] pouch; with biopsy, single or multiple

42.24 closed [endoscopic] biopsy of esophagus

42.33 endoscopic excision or destruction of lesion or tissue of esophagus

43.11 percutaneous endoscopic gastrostomy [PEG]

43.41 endoscopic excision or destruction of lesion or tissue of stomach

44.1X diagnostic procedures on stomach

44.22 endoscopic dilation of pylorus

44.43 43234 43235 43236 43237

43238

43239 43240 43241

endoscopic control of gastric or duodenal bleeding

upper gastrointestinal panendoscopy using a small-diameter endoscope

upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed submucosal injection(s), any substance upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with endoscopic ultrasound examination limited to the esophagus upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultraso upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transmural drainage of pseudocyst

upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as

Lower GI Endoscopy

CPT

CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT CPT

CPT

CPT ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure

appropriate; with transendoscopic intraluminal tube or catheter placement

43242 43243 43244 43245 43246 43247 43248 43249 43250 43251 43255 43256 43258

43259

upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examina upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with injection sclerosis of esophageal and/or gastric varices upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with band ligation of esophageal and/or gastric varices upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie) upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with insertion of guide wire followed by dilation of esophagus over guide wire upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with balloon dilation of esophagus (less than 30 mm diameter) upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic stent placement (includes predilation) upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

45.24 flexible sigmoidoscopy

45.25 closed [endoscopic] biopsy of large intestine

45.28 other diagnostic procedures on large intestine

ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure ICD-9 Procedure

CPT

CPT

CPT CPT CPT

CPT

Proctosigmoidosco

py

CPT

CPT

CPT

CPT CPT

45.29 other diagnostic procedures on intestine, site unspecified

45.3X local excision or destruction of lesion or tissue of small intestine

48.21 transabdominal proctosigmoidoscopy

48.23 rigid proctosigmoidoscopy

48.24 closed [endoscopic] biopsy of rectum

48.29 other diagnostic procedures on rectum, rectosigmoid and perirectal tissue

48.36 [endoscopic] polypectomy of rectum

49.31 endoscopic excision or destruction of lesion or tissue of anus

45.42 endoscopic polypectomy of large intestine

45.43 endoscopic destruction of other lesion or tissue of large intestine

810 45300 45303 45305 45307 45308 45309 45315

45317

45320 45321

lower GI endoscopy

proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)

proctosigmoidoscopy, rigid; with biopsy, single or multiple

proctosigmoidoscopy, rigid; with removal of foreign body proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)

proctosigmoidoscopy, rigid; with decompression of volvulus

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