How To Use CPT Code 43756

CPT 43756 describes the diagnostic procedure of duodenal intubation and aspiration, which involves the insertion of a tube into the duodenum to obtain a specimen of duodenal secretions for analysis. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43756?

CPT 43756 is a code used to describe the diagnostic procedure of duodenal intubation and aspiration. During this procedure, a healthcare provider inserts a tube into the duodenum, the first part of the small intestine, to obtain a specimen of duodenal secretions for analysis. The provider may administer a stimulant to the stomach to induce acid production before obtaining the specimen. The collected specimen is then sent to the laboratory for further analysis.

2. Official Description

The official description of CPT code 43756 is: ‘Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture).’ This code specifically includes the use of image guidance during the procedure and covers the collection of a single specimen for analysis, such as a bile study for crystals or an afferent loop culture.

3. Procedure

1. To perform CPT 43756, the healthcare provider begins by appropriately prepping and anesthetizing the patient.
2. The provider then passes a tube through either the mouth or the nose, through the esophagus and stomach, and into the duodenum under image guidance.
3. Once the tube is in place, the provider administers a stimulant, such as gastrin, intravenously to stimulate acid production in the stomach.
4. Using a syringe attached to the tube, the provider aspirates, or suctions, the contents of the duodenum, collecting a specimen of duodenal secretions.
5. The collected specimen is then sent to the laboratory for analysis.
6. After the procedure, the provider removes the tube and checks for any signs of injury as the tube is pulled out.

4. Qualifying circumstances

CPT 43756 is performed for diagnostic purposes to determine the type of disease and its causes. It is used when there is a need to obtain a specimen of duodenal secretions for analysis. The procedure requires the use of image guidance to ensure accurate placement of the tube into the duodenum. The collected specimen may be used for various analyses, such as a bile study for crystals or an afferent loop culture.

5. When to use CPT code 43756

CPT code 43756 should be used when a healthcare provider performs the diagnostic procedure of duodenal intubation and aspiration to obtain a single specimen of duodenal secretions for analysis. It is important to note that this code is specifically for the collection of a single specimen and includes the use of image guidance during the procedure.

6. Documentation requirements

To support a claim for CPT 43756, the healthcare provider must document the following information:

• Reason for performing the procedure and the need for obtaining a specimen of duodenal secretions
• Details of the image guidance used during the procedure
• Date and time of the procedure
• Description of the specimen collected and its intended analysis
• Any complications or injuries encountered during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43756, ensure that the procedure meets the criteria outlined in the official description. The use of image guidance and the collection of a single specimen are essential components of this code. It is important to note that CPT code 43756 should not be reported with other codes unless specific circumstances warrant it. Proper documentation is crucial to support the billing of this procedure.

8. Historical information

CPT code 43756 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates or changes to the code since its addition.

9. Examples

1. A gastroenterologist performing duodenal intubation and aspiration to obtain a specimen for a bile study to analyze the presence of crystals.
2. A surgeon using image guidance to insert a tube into the duodenum and collect a specimen of duodenal secretions for an afferent loop culture.
3. An internist performing duodenal intubation and aspiration to obtain a specimen for bacterial analysis of the proximal loop of the duodenum and jejunum.
4. A gastroenterologist using image guidance to perform duodenal intubation and aspiration for diagnostic purposes in a patient with suspected duodenal pathology.
5. A healthcare provider performing duodenal intubation and aspiration to obtain a specimen of duodenal secretions for analysis in a patient with unexplained gastrointestinal symptoms.
6. A gastroenterologist using image guidance to collect a specimen of duodenal secretions for analysis in a patient with suspected malabsorption syndrome.
7. A surgeon performing duodenal intubation and aspiration to obtain a specimen for a bile study to investigate the presence of gallstones.