# 43237 &  43259



## catharine (Sep 18, 2017)

Can anyone please tell me the real difference  between these codes and what should be in the dictation to indicate which of these codes to use?    Thank-you


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## Hayley_Sutton (Sep 25, 2017)

*43237 vs 43259*

Basically, 43237 is when the EUS view 1 or 2 structures (either the esophagus, stomach, or duodenum) and 43259 is if all 3 structures are examined with the EUS. 

This is from CPT assistant, January 2016:

"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 UGI structures be examined in order to report this code. Keep in mind that ultrasound always involves structures adjacent to the UGI structures, not just the walls of these organs. Code selection is based upon whether one, two, or all three regions are examined.



For example, code 43237 should be reported if the ultrasound examination is for one or two regions, not all three regions. If all three regions (or a surgically altered stomach in which the jejunum is examined distal to the anastomosis) are examined, the correct code to report is 43259, Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis."

Hayley Sutton, CPC, CCA


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## Nancy Klein (Sep 10, 2018)

*43232, 43238 or 43242*

Help Please:  
In this op report which EUS fine needle bx is correct:  "...after adequate sedation, linear echoendoscope was inserted into the oropharynx.  Scope was advanced with partial visualization to the duodenal bulb.  CBD and PD were seen.  Head of the pancreas looked unremarkable.  The scope was withdrawn to the stomach.  Pancreatic tail, neck and body looked unremarkable.  PD in the neck, body and tail unremarkable.  The scope was rotated and liver looked unremarkable.  Left lobe of liver examined and no lesions were noticed inside the liver.  It was hypoechoic looking.  22 guage sharp core needle was passed through the scope and 3 passes were made and biopsy specimens were sent for pathology examination."  
How can you tell which areas were examined with an ultra sound?  

Any response would be greatly appreciated.


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