PCS Code for Hemoclip of AVM during Colonoscopy...?0DQK8ZZ (repair) which would "take" the DRG.

Postop DX: five ascending colon AVMs status post submucosal injection, argon plasma coagulation and hemoclip placement. Cecal polyp status post APC ablation.

In the cecum, there was a 4mm AVM, I used the APC to destroy the AVM. There was a 4 mm polyp there that I destroyed using the Argon Plamsa Coagulator performing ablation. There were four more AVMs noted ranging in size from 4 mm to 1.5 cm. I injected the remainder of these with saline and then used the APC to destroy them. I then placed Hemoclips over the two larger AVMs. Patient tolerated the procedure well and no apparent complications.

I feel all of this would be considered destruction...even the hemoclip was used to destruct the AVM...coder feels a repair code should be used (if that is used it would take this short stay to a major OR procedure)...I know there is a Coding Clinic for control of bleeding duodenal ulcer where it states to use repair but to me that was used due to repairing the site of the ulcer.

Anyone have any thoughts on this?

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