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