Surgery/Digestive System (July 2009)

July 2009 page 10b Surgery: Digestive System, 43273, 43262 (Q&A) Question: Our gastroenterologist performed an endoscopic pancreatoscopy (code 43273 ) and a sphincterotomy (code 43262 ). Should the sphincterotomy be separately reported or is this procedure inherent and inclusive to the endoscopic pancreatoscopy? Answer: Code 43262 , Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy, is for a distinct procedure that is separately reported when performed in conjunction with code 43273 , Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreatic duct(s) (List separately in addition to code(s) for primary procedure). The parenthetical following code 43273 will be...

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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 discusses a coding question from the surgery/digestive system category and focuses on how two CPT procedures are addressed in relation to one another. It is intended for coding professionals, compliance staff, and clinicians who document or report gastrointestinal endoscopic services. The content covers the scenario presented in the Q&A, the CPT context for the procedures involved, and a note about an upcoming CPT 2010 parenthetical revision.

Why This Topic Matters

Readers use this type of guidance to understand how CPT editorial changes and reporting clarifications affect digestive system procedure reporting. It is relevant for accurate claim preparation, documentation review, and staying current with CPT updates.

Article Sections

  1. July 2009 page 10b

    A brief Q&A focused on digestive system endoscopic services and CPT reporting context. The section addresses an immediate guidance note and references a future CPT revision.

What You Will Learn

  • The general CPT reporting issue discussed for digestive system endoscopic procedures
  • How the article frames a Q&A involving related endoscopic services
  • Why the article references a future CPT parenthetical update
  • What type of guidance CPT Assistant provided in July 2009

Who Should Read This

  • Medical coders
  • Coding auditors
  • Compliance staff
  • Gastroenterology practices
  • Physician documentation staff

Codes Discussed


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