Why should biopsies be taken at the time of endoscopy?

Understanding Health Insurance: A Guide to Billing and Reimbursement
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Chapter9: Cms Reimbursement Methodologies
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Why should biopsies be taken at the time of endoscopy?

Case 1:
A 62-year-old man presented to the A& E following hematemesis and melena. He suffered no
pain. His past medication history included Non ST elevated myocardial infarction (NSTEMI)
for which he had undergone Percutaneous coronary intervention (PCI and) bare metal stent
insertion 4 months previously. Mr BD stopped smoking 2 years previously, drinks alcohol in
moderation and is not obese. He was taking the following prescribed medications:
Aspirin 75 mg
Clopidogrel 75 mg
Ramipril 2.5 mg BID
Simvastatin 40 mg daily
Atenolol 100 mg
GTN spray prn
On investigation MR BD's haemoglobin concentration was 8 g/dL. His BP was 98/60 with a
PR 120 beats per minute. There was no jaundice. Electrolytes were normal and INR was 1.0.
Endoscopy revealed an actively bleeding gastric ulcer.
1. What immediate treatment should Mr BD receive?
2. What treatment should he receive at the time of endoscopy?
Transcribed Image Text:Case 1: A 62-year-old man presented to the A& E following hematemesis and melena. He suffered no pain. His past medication history included Non ST elevated myocardial infarction (NSTEMI) for which he had undergone Percutaneous coronary intervention (PCI and) bare metal stent insertion 4 months previously. Mr BD stopped smoking 2 years previously, drinks alcohol in moderation and is not obese. He was taking the following prescribed medications: Aspirin 75 mg Clopidogrel 75 mg Ramipril 2.5 mg BID Simvastatin 40 mg daily Atenolol 100 mg GTN spray prn On investigation MR BD's haemoglobin concentration was 8 g/dL. His BP was 98/60 with a PR 120 beats per minute. There was no jaundice. Electrolytes were normal and INR was 1.0. Endoscopy revealed an actively bleeding gastric ulcer. 1. What immediate treatment should Mr BD receive? 2. What treatment should he receive at the time of endoscopy?
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