AMA CPT® Assistant - 2007 Issue 5 (May)

Surgery: Digestive System (May 2007)

May 2007 page 10a Coding Communication:Surgery: Digestive System Question The patient had an upper gastrointestinal endoscopy (43234) without the administration of moderate (conscious) sedation. Because the moderate sedation symbol is listed with this code in CPT 2007, should modifier 52, Reduced services, be appended to the procedure code? AMA Comment No. Code 43234 is used to report an upper gastrointestinal endoscopy, simple primary examination, using a small diameter flexible endoscope that is swallowed by the patient. As stated in Appendix G of the CPT codebook, in circumstances where a procedure listed in Appendix G (Moderate [Conscious] Sedation) and the...

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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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