Practice Quiz

Medical Coding

Category - Medicine

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A patient needs to have a transoral flexible esophagoscopy to treat abnormal tissue in the esophagus. This will be done by providing photodynamic therapy applying light to ablate the abnormality by activating photosensitive drugs. This patient’s procedure takes 22 minutes. What are the correct CPT codes for this procedure?
  1. 96567
  2. 43200, 96567, -52
  3. 43200, 96567
  4. 43200, 96571
Explanation
Answer: B - 43200 is the correct code for transoral flexible esophagoscopy. Code 96567 is the correct add-on code for photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drugs. Modifier -52 is correct because less than 23 minutes was spent doing this procedure.

Code 96567 is incorrect because this code is not involving an endoscopy. Add-on code 96571 is incorrect because this code is for each additional 15 minutes past the initial 30 minutes, and this patient’s procedure took less than 30 minutes.
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