Surgery: Digestive System (January 2004)

January 2004 page 26c Coding Consultation:Questions and Answers Digestive System, 43245 (Q&A) Question When an EGD with biopsy and dilation of gastric outlet for obstruction are performed during the same endoscopic session, how should these procedures be reported? AMA Comment Code 43245, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie), describes the EGD with dilation of gastric outlet, and code 43239-51, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple...

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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 premium article explains a coding consultation from CPT Assistant focused on Digestive System endoscopy reporting in a January 2004 question-and-answer format. It is useful for coders, auditors, and billing professionals who work with surgical gastrointestinal services and want to understand the general topics covered, including same-session procedure reporting and modifier use.

Why This Topic Matters

Articles like this help coding professionals stay aligned with published AMA guidance on how to interpret and report related procedures within the Digestive System section. It is relevant to anyone reviewing claims, coding policies, or documentation for gastrointestinal endoscopic services.

Article Sections

  1. Coding Consultation: Questions and Answers

    Introduces a coding consultation format centered on a Digestive System endoscopy reporting question. The section frames the scenario and the related guidance discussed by the AMA comment.

What You Will Learn

  • The general reporting issues raised when more than one digestive system endoscopic service is performed in the same session.
  • How AMA CPT Assistant guidance is presented in a question-and-answer format.
  • The kinds of modifier and same-session reporting topics addressed in the article.
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  • type

Who Should Read This

  • Medical coders
  • Coding auditors
  • Billing professionals
  • Compliance staff
  • Revenue cycle teams

Codes Discussed

Modifiers Discussed


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