Outpatient Facility Coding Alert
Enter the Endosonoscope Through 43237 When Inserted Through Mouth
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Question: The physician performed an endoscopic ultrasound examination (EUS) stating, “The endosonoscope was introduced through the mouth and advanced to the second part of the duodenum. The upper EUS was accomplished without difficulty.” The physician was using the ultrasound to look at the pancreas. My physician did not have a patient with a surgically altered stomach. Which code should we use?
Colorado Subscriber
Answer: CPT® code 43237 (Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures) is an appropriate code for this scenario. An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach and duodenum by means of a flexible endoscope through the mouth hence duodenum cannot be scoped without scoping the stomach. The endosonoscope was introduced through the mouth and advanced to the second part of the duodenum; hence, 43237 is the appropriate code.
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