A patient with a suspected pancreatic mass presents for an EGD with endoscopic ultrasound (EUS) and core needle biopsy. The upper endoscope and the linear echoendoscope were used to perform the examination and biopsies of the gastrointestinal tract and the pancreas and biliary tract. During the EUS, the pancreas was evaluated and no pancreatic mass or other abnormalities were found. A 25-gauge core needle biopsy of the pancreas was performed and core tissue was collected. There were no pancreatic abnormalities found during the endoscopic ultrasound. Is it appropriate to assign CPT code 43238 when the code descriptor states “transmural fine needle aspiration/biopsies,” and a core needle biopsy of the pancreas is performed?
Assign CPT code 43238, Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures), for the EGD with the endoscopic ultrasound and core biopsy of the pancreas. The pancreas would be considered an “adjacent structure.”
Although not specifically stated in the code descriptor, the core needle biopsy is captured in this code.