AMA CPT® Assistant - 2018 Issue 7 (July)

Surgery: Digestive System (Q&A) (July 2018)

July 2018 page 14b Surgery: Digestive System Question: May code 43239 (esophagogastroduodenoscopy [EGD]) be separately reported on the same date of service as code 43249? Answer: Yes, CPT guidelines permit the reporting of multiple endoscopy codes on the same date of service, as appropriate. Codes 43249, Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter), and 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple, should be reported with modifier 59, Distinct Procedural Service, appended because they describe distinctly different procedures. Both codes, however, include upper gastrointestinal diagnostic endoscopy service (43235), and payment adjustments...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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