CPT^® 43242, Under Esophagogastroduodenoscopy Procedures

The Current Procedural Terminology (CPT^®) code 43242 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 where, under endoscopic ultrasound guidance, he carries out a fine needle aspiration or biopsy in or through the wall of the upper GI tract or the jejunum distal to its anastomosis (connection) to a surgically altered stomach.

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 43242 ? Start a discussion here

EUS and EGD BX 43242 and 43239

[QUOTE="cfostercpc, post: 495690, member: 41646"] My physician does EUS and we bill these codes together as usually the 43242 is a bx which is usually aspirating fluid from a pancreatic cyst ect and t... [ Read More ]

EUS and EGD BX 43242 and 43239

My physician does EUS and we bill these codes together as usually the 43242 is a bx which is usually aspirating fluid from a pancreatic cyst ect and the 43239 is a tissue biopsy usually from the stoma... [ Read More ]

EUS and EGD BX 43242 and 43239

Hello, I am wondering if 43242 and 43239 can be billed together, I looked it up both codes thru the NCCI edits and both are allowed with a 59 modifier on the 43239, please advise. Thank you... [ Read More ]

EUS with celiac plexus block help please

CODING FOR GASTRO: My doctor did an EGD W/ BX & EUS W/CELIAC BLOCK & EUS W/ FNA. I CODED AS FOLLWED 43253 , 43242 & 43239. Reason being when I look up 64680 it says use 43253 for the Celiac injection.... [ Read More ]

GI coding

Does code 43239 include transendoscopic ultrasound-guided intramural or transmural fine needle aspiration biopsy including endoscopic ultrasound examination of the esophagus, stomach and duodenum? Th... [ Read More ]

43237 & 43259

[b]43232, 43238 or 43242[/b] 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 adva... [ Read More ]

Cpt 43237 & 43259

[b]The difference between 43239 and 43259[/b] This information is from [I]Optum Encoder Pro[/I]: 43259-Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, includi... [ Read More ]

help with coding this procedure- am I missing something? egd eus fna adequacy

** good morning all I am coding this procedure done by my physician and I am wondering if I am missing anything by coding it as a 43242. Input is appreciated. have a great day! ""EGD/EUS/FNA-Cor... [ Read More ]

Help with EUS with FNA

[b]Limited vs multiple[/b] The difference is whether or not the EUS was limited to one area or is multiple areas were viewed. Your EGD speaks of the Esophagus, stomach and duodenum, the EUS speaks o... [ Read More ]

Help with EUS with FNA 43242 vs 43238

[B]I am not sure if I am reading this code description correctly. Can anyone tell me what code would be most appropriate for this report and why choose one code over the other? I am having a difficult... [ Read More ]

View All