AMA CPT® Assistant - 2016 Issue 1 (January)

Surgery: Digestive System (Q&A) (January 2016)

January 2016 page 11a Surgery: Digestive System Question: For CPT code 43237, Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures, do the terms "limited to" and "or" in the descriptor indicate that this code is appropriate to report if an esphagogastroduodenoscopy (EGD) is performed and an ultrasound examination is performed on any of the upper gastrointestinal (UGI) structures (eg, esophagus, stomach, or duodenum)? Answer: Yes, EGD code 43237 may be reported when the endoscopic ultrasound examination is performed on any of the UGI structures. It is not required that all...

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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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