Surgery/Digestive System (May 2009)

May 2009 page 8b Surgery: Digestive System, 43235, modifier 25, 91110, modifier 52 (Q&A) Question: A patient is scheduled to have a video capsule endoscopy for evaluation of her small bowel. She has mechanical dysphagia and is unable to swallow the capsule. The physician places the capsule directly into her stomach or small bowel with an endoscope. What is the correct coding for the endoscopic placement of the capsule? Answer: CPT code 43235 , Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is a coding question-and-answer from a CPT-focused surgery/digestive system update. It addresses endoscopic capsule placement in the setting of swallowing difficulty and discusses the broader reporting context for upper gastrointestinal endoscopy and capsule-based gastrointestinal tract imaging. It is intended for coders, billers, and compliance staff who work with digestive system procedures and CPT modifier usage.

Why This Topic Matters

Digestive system procedure coding can be affected by how a service is performed and how completely the examined anatomy is evaluated. This article helps readers understand the reporting context for an abbreviated endoscopic service and associated modifier use within a capsule endoscopy scenario.

Article Sections

  1. May 2009 page 8b

    A short Q&A item from a CPT Assistant digestive system update. The section centers on endoscopic and capsule endoscopy reporting in a specific clinical scenario.

What You Will Learn

  • How a digestive system coding Q&A is structured in a CPT Assistant update
  • What topics are addressed in capsule endoscopy-related reporting
  • How the article frames endoscopic services in the context of a shortened or incomplete examination
  • Which CPT modifier concepts are discussed in relation to the scenario

Who Should Read This

  • Medical coders
  • Coding auditors
  • Billing specialists
  • Compliance professionals
  • Gastroenterology practice staff

Codes Discussed

Modifiers Discussed


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