Gastroenterology Coding Alert

Question: The provider performs endoscopic ultrasound with optical endomicroscopy (OE) and fine needle aspiration of a pancreatic cyst. How do we report this procedure?

Texas Subscriber

Answer: You may report the Endoscopic Ultrasound (EUS) along with Fine Needle Aspiration (FNA) with 43238 (Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy[s], [includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures])  if the EUS is limited to esophagus, stomach or duodenum.

However, in case the procedure includes esophagus, stomach as well as duodenum, you may report 43242 (… [includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis]).

Remember not to report these codes more than once per session. You may report optical microscopy using 43252 (Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy). You will need to report supply of contrast agent separately.