CPT^® 43236, Under Esophagogastroduodenoscopy Procedures

The Current Procedural Terminology (CPT^®) code 43236 as maintained by American Medical Association, is a medical procedural code under the range - Esophagogastroduodenoscopy Procedures.

Additional/Related Information

Tabs

Summary

The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum (first part of the small intestine). The provider performs one or more injections into the submucosa (the tissue below the mucous membrane).

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 43236 ? Start a discussion here

Egd with biopsies and botox injections

Patient came in for Egd. Ended up taking biopsies and injection due to dysphagia. I came up with 43239, 43236-59. Does this make sense or can I only bill one procedure? Thx for your help.... [ Read More ]

Botox for achalasia

I have been fighting with BCBS of MI regarding Botox. They state I cannot bill 43236 with J0585. This is how I have billed all Botox cases for the past 2 years and this is the first time they have d... [ Read More ]

EGD with control of bleed AVM

I have this same scenario but there is no response to the question. Provider insists 43255 is the appropriate CPT due to the "risk of bleed" but documents "non-bleeding ...." for both identified ulce... [ Read More ]

Billing for a PUSH enteroscopy with india ink tatoo

My provider did a PUSH enteroscopy with India ink tattoo. the biopsy codes is 44361 but I could not find a code for submucosal injection in the enteroscopy series? thinking of 43236 or should we g... [ Read More ]

Modifier 52

Hi there - We have a claim that went out with these 2 codes: 43239-52 43236-59 It was denied for incorrect modifier. Should we also add modifier 52 to 43236? Thank you so much! Johncy... [ Read More ]

botox injection - what injection code

We do EGD with Botox injections and code with 43236. We have found that the Botox Drug HCPCS Code will need to have a pre-cert for payment if you are billing for the drug with the CPT code. Most ins... [ Read More ]

To 43236 or not to 43236? That is the question

You cannot bill the 43236. Unlike colonoscopies, upper endoscopy injections do require the 59 modifier. Since it is the same site, adding a 59 would be erroneous, as you would be indicating it was a s... [ Read More ]

To 43236 or not to 43236? That is the question

The op report states "A benign high grade instrinsic stricture was seen in the GE junction that did not allow the endoscope to traverse. 4 .05 ml kenalog injections were successfully applied for drug... [ Read More ]

Esophageal dilation and steroid injection

Can you charge an esophageal dilation and a steroid injection together? 43249 and 43236-59 on the same stricture area.... [ Read More ]

EGD with Botox

[b]Botox injection for achalasia[/b] Does anyone have any coding advice on billing for the Botox drug J0585 when injected during EGD 43236 in an ASC? Can you bill separately for the Botox drug J0585... [ Read More ]

View All