AAPC - Back to school
Results 1 to 4 of 4

Thread: 43234

  1. #1

    Default 43234

    AAPC: Back to School

    Please help. My physician did an upper GI endoscopy. The endoscope was introduced through the mouth and advanced to the gastric cardia. I'm not sure if 43234 is the correct code. I'm being told that the patient has to "swallow" the scope in order to use 43234. Does anyone have any advice on this?

  2. #2
    Join Date
    Apr 2007


    Below is the description for the cpt 43234...I don't see anywhere that the patient needs to 'swallow' the scope...

    The physician examines the upper gastrointestinal tract. The physician passes an endoscope through the patient's mouth into the esophagus. The esophagus, stomach, duodenum, and sometimes the jejunum are viewed. (This is for simple primary examination)

    On the other hand, if the doc is doing the procedure for diagnostic purposes I would go with the 43235 or 43239 if a biopsy was done.

    Hope this helps!

  3. #3


    For codes 43235 and 43239, does the endoscope need to be advanced to the duodenum and/or jejunum? If so, would a reduced services modifier be indicated for the OP's procedure?


  4. #4
    Join Date
    Apr 2007


    The intent is to reach the duodenum and sometimes the jejunum...for an incomplete procedure, then I would append modifier 52...If the doc only examines the esophagus, then I would consider coding 43200.

    Hope this helps, open to more feedback!!

Similar Threads

  1. 43234 vs. 43235
    By kingkong in forum Gastroenterology
    Replies: 1
    Last Post: 05-19-2010, 06:12 AM
  2. 43234 vs. 43235
    By kingkong in forum General Surgery
    Replies: 2
    Last Post: 05-03-2010, 11:14 AM
  3. 43234 with repeat 43244
    By dlk in forum Gastroenterology
    Replies: 0
    Last Post: 07-15-2009, 08:48 AM
  4. 43234 with repeat 43244
    By dlk in forum Gastroenterology
    Replies: 0
    Last Post: 07-15-2009, 08:12 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.