How To Use CPT Code 43757

CPT 43757 describes the diagnostic procedure of duodenal intubation and aspiration, which involves the insertion of a tube into the duodenum to collect multiple fractional specimens of duodenal secretions for analysis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43757?

CPT 43757 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, which is the first part of the small intestine. The purpose of this procedure is to collect multiple fractional specimens of duodenal secretions for further analysis in the laboratory. The provider may administer a stimulant to initiate the production of pancreatic juices and bile, which are then collected through the tube for analysis.

2. Official Description

The official description of CPT code 43757 is: ‘Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring that they are appropriately prepped and anesthetized.
2. Under image guidance, the provider inserts a tube through either the mouth or the nose, passing it through the esophagus and stomach, and into the duodenum.
3. The provider suctions the fluid in the duodenum for baseline analysis.
4. Next, the provider administers secretin intravenously to stimulate pancreatic secretion and checks for any undesired side effects of the secretin administration.
5. If there are no side effects, the provider suctions out multiple samples of duodenal fluid for further analysis in the laboratory.
6. Finally, the provider removes the tube and checks for any injury as they gently pull it out.

4. Qualifying circumstances

CPT 43757 is typically performed on patients who require diagnostic evaluation of their duodenal secretions. The procedure may be necessary to determine the type of disease and its causes. It is important to note that this procedure requires the use of a single or double lumen tube, which allows for the collection of multiple fractional specimens. The provider may also administer a drug, such as secretin, to stimulate pancreatic or gallbladder secretion during the procedure.

5. When to use CPT code 43757

CPT code 43757 should be used when a healthcare provider performs the diagnostic procedure of duodenal intubation and aspiration. This code is appropriate when the provider collects multiple fractional specimens of duodenal secretions using a single or double lumen tube, with or without the administration of a drug to stimulate pancreatic or gallbladder secretion. It is important to ensure that the procedure includes image guidance and is performed for diagnostic purposes rather than therapeutic purposes.

6. Documentation requirements

To support a claim for CPT code 43757, the healthcare provider must document the following information:

• Patient’s medical history and reason for performing the procedure
• Details of the procedure, including the use of image guidance and the type of tube used (single or double lumen)
• Date and duration of the procedure
• Administration of any drugs, including the name and dosage
• Results of the procedure, including the collection of multiple fractional specimens
• Any complications or adverse effects
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 43757, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of image guidance, collection of multiple fractional specimens, and administration of drugs should be documented and supported by medical necessity. It is also important to follow any additional guidelines provided by payers or coding authorities. CPT code 43757 should not be reported with other codes that include similar procedures, such as fluoroscopically guided replacement of a gastrostomy tube or endoscopic placement of a gastrostomy tube.

8. Historical information

CPT code 43757 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 performs duodenal intubation and aspiration on a patient with suspected pancreatic disease to collect multiple fractional specimens for analysis.
2. A physician administers secretin during the duodenal intubation and aspiration procedure to stimulate pancreatic secretion and collect duodenal fluid samples for analysis in a patient with unexplained abdominal pain.
3. A surgeon performs duodenal intubation and aspiration on a patient with suspected gallbladder disease to collect multiple fractional specimens of duodenal secretions for further analysis.
4. A gastroenterologist uses image guidance to perform duodenal intubation and aspiration on a patient with chronic diarrhea to collect duodenal fluid samples for analysis and determine the underlying cause of the symptoms.
5. A healthcare provider performs duodenal intubation and aspiration on a patient with malabsorption issues to collect multiple fractional specimens of duodenal secretions and assess the absorption of nutrients.