With so many coding changes taking place at regular intervals, coding for your gastroenterology coding practice is never easy.
You are constantly surrounded by tough coding situations and tough questions and answers. If you have queries on coding and reimbursement of dysphagia evaluation and treatment, here are some common concerns to help your understanding.
There are six ICD-9 codes that you should use to diagnose dysphagia. ICD-9 codes that are commonly used by practices to provide an appropriate dysphagia diagnosis are 787.20, 787.21, 787.22, 787.23, 787.24, 787.29.
Gastroenterologists should report 438.82 coupled with an additional code from the 787.20, "787.29 series for dysphagia due to the late effects of cerebrovascular disease. Reporting the combined ICD-9 codes should identify the specific type of dysphagia, if proper.
As far as CPT codes for dysphagia-related services are concerned, you should report these codes: 92526, 92610, 92611, 92612, 92614, and 92616. But then for most gastroenterology practices, 92526 is the only choice while reporting treatments associated with dysphagia related to any of the upper throat mechanics, as per the National Government Services LCD.
What’s more, the CCI prohibits combining 92526 with other CPTs when the focus of the treatment is for swallowing. For example, you should never use the 97xxx series of codes while billing for dysphagia treatment. Other codes that you will not be able to use with 92526 are 92511, 92520, 97032, 97110, 97112, 97150, 97530, 97532, among others.
And what about restrictions CCI has imposed on dysphagia treatment codes? CCI edits on dysphagia-related services prevents billing the codes together or requires using modifier 59 to indicate that they are distinctly separate procedures.
You are constantly surrounded by tough coding situations and tough questions and answers. If you have queries on coding and reimbursement of dysphagia evaluation and treatment, here are some common concerns to help your understanding.
There are six ICD-9 codes that you should use to diagnose dysphagia. ICD-9 codes that are commonly used by practices to provide an appropriate dysphagia diagnosis are 787.20, 787.21, 787.22, 787.23, 787.24, 787.29.
Gastroenterologists should report 438.82 coupled with an additional code from the 787.20, "787.29 series for dysphagia due to the late effects of cerebrovascular disease. Reporting the combined ICD-9 codes should identify the specific type of dysphagia, if proper.
As far as CPT codes for dysphagia-related services are concerned, you should report these codes: 92526, 92610, 92611, 92612, 92614, and 92616. But then for most gastroenterology practices, 92526 is the only choice while reporting treatments associated with dysphagia related to any of the upper throat mechanics, as per the National Government Services LCD.
What’s more, the CCI prohibits combining 92526 with other CPTs when the focus of the treatment is for swallowing. For example, you should never use the 97xxx series of codes while billing for dysphagia treatment. Other codes that you will not be able to use with 92526 are 92511, 92520, 97032, 97110, 97112, 97150, 97530, 97532, among others.
And what about restrictions CCI has imposed on dysphagia treatment codes? CCI edits on dysphagia-related services prevents billing the codes together or requires using modifier 59 to indicate that they are distinctly separate procedures.
