I have researched this & can find nothing. New GI doc wants to charge 43432 (EGD with EUS) & 93976. I feel the Doppler would be part of the EUS. Does anyone have any coding info regarding the Doppler when doing 43432.
Op Note: Scope easily traversed the GEJ into the stomach. The stomach was normally distensible. The distal gastric body, angularis, antrum, & pylorus was examined & normal. The scope easily traversed the pylorus into the duodenal bulb & post bulbar duodenum & were normal. Scope was brought back to the stomach & retroflexion performed. The proximal gastric body, cardia, & fundus were normal. Scope was straightened & removed. The radial EUS scope was advanced into the esophagus, with no evidence of abnormal lymphadenopathy. Scope was advanced into the stomach & pancreatic body & tail examined. The main pancreatic duct was slightly dilated to about 4 mm in the body & tail of the pancreas. The pancreatic parenchyma was without calcification or masses. The pancreas did not have a classic normal appearance to it, there appeared to be some fatty replacement of the parenchyma. The pancreatic duct was noted to be free of tortuosity. The celiac axis, portal vein, & splenic vessels were normal. The scope was advanced into the duodenum & pancreatic head, CBD & main pancreatic duct were examined. There was slight dilation of CBD to roughly 6mm & main pancreatic duct to roughly 5mm. There was a multicystic lesion with septations roughly 3.2 x 2.4 cm. There were no obvious associated masses or mural nodules. The scope was completely removed & the linear EUS scope was advanced into the stomach & duodenum. After Color Doppler confirmed that there were not intervening blood vessels between the scope & lesion 2 passes with a 22-gauge expect needle were made into the lesion. Somewhat viscous fluid was aspirated sent off for CEA & amylase. The scope was completely removed & procedure terminated.
Op Note: Scope easily traversed the GEJ into the stomach. The stomach was normally distensible. The distal gastric body, angularis, antrum, & pylorus was examined & normal. The scope easily traversed the pylorus into the duodenal bulb & post bulbar duodenum & were normal. Scope was brought back to the stomach & retroflexion performed. The proximal gastric body, cardia, & fundus were normal. Scope was straightened & removed. The radial EUS scope was advanced into the esophagus, with no evidence of abnormal lymphadenopathy. Scope was advanced into the stomach & pancreatic body & tail examined. The main pancreatic duct was slightly dilated to about 4 mm in the body & tail of the pancreas. The pancreatic parenchyma was without calcification or masses. The pancreas did not have a classic normal appearance to it, there appeared to be some fatty replacement of the parenchyma. The pancreatic duct was noted to be free of tortuosity. The celiac axis, portal vein, & splenic vessels were normal. The scope was advanced into the duodenum & pancreatic head, CBD & main pancreatic duct were examined. There was slight dilation of CBD to roughly 6mm & main pancreatic duct to roughly 5mm. There was a multicystic lesion with septations roughly 3.2 x 2.4 cm. There were no obvious associated masses or mural nodules. The scope was completely removed & the linear EUS scope was advanced into the stomach & duodenum. After Color Doppler confirmed that there were not intervening blood vessels between the scope & lesion 2 passes with a 22-gauge expect needle were made into the lesion. Somewhat viscous fluid was aspirated sent off for CEA & amylase. The scope was completely removed & procedure terminated.