Gastroenterology Coding Update: Rid Your Dysphagia Coding Woes

By Author: Angela Martin
Total Articles: 206
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Often, diagnosing dysphagia isn't cause for alarm among gastroenterology practices. Occasional difficulty in swallowing may simply occur when you eat too fast or do not chew your food well. However persistent difficulty in swallowing may point to a serious medical condition requiring treatment. For diagnostic gastroenterology, dysphagia is thought of as an important symptom for diseases of the esophagus.


If you are not careful, you might get lost on the sea of options available in reporting dysphagia diagnoses and procedure. Draw up more reserved ammo by keeping these three tips in mind.


Fit diagnosis to its proper type
Doctors normally direct patients who complain about any type of upper throat swallowing problem to a speech-language pathologist (SLP) for an appropriate swallow evaluation. SLPs are the ones who actually diagnose dyspagia, determine what type and develop a treatment plan.


With 92526, one CPT fits all
While reporting treatments associated with dysphagia related to any of the upper throat mechanics, all that you need to remember is the ...
... lone code 92526. CPT code 92526 is a comprehensive code that includes most aspects of dysphagia treatment. Don't use additional CPT codes in conjunction with 92526 when the focus of the treatment is for swallowing. When billing for dysphagia treatment, do not use the 97xxx series of codes. CPT code 92526 is an untimed code, billed as 1 unit per day.


Support treatment code with DPNS Therapy
As treatment for pharyngeal dysphagia (787.23) could involve DPNS therapy, you should think about reporting DPNS alongside the treatment without worrying that you won't get paid for it.


However, there's a catch. You can bill DPNS only in addition to covered care service. DPNS therapy is non-covered as its efficacy hasn't been clearly demonstrated as reasonable and necessary. Its use alongside a proper treatment code won't be cause for any denial.


Case-to-case Tens treatment: First ensure medical necessity


A doctor may also include transcutaneous electrical nerve stimulation (TENS) in the treatment plan. To report this service, you have three code options.


For more tips to clear up your Dysphagia Coding woes and for all gastroenterology coding update, sign up for an audio conference.