(2023) EGD With Biopsy | EUS CPT Codes

If the physician performing the original diagnostic endoscopy has access to the EUS and the clinical situation requires an EUS, the EUS may be done simultaneously.

The procedure, diagnostic, and EUS is reported under the same code, CPT 43259. This code conforms to CPT guidelines for the indented codes. The service represented by the indented code, in this case, code CPT 43259 for EUS, includes the service represented by the unintended code preceding the list of indented codes.

Therefore, when a diagnostic examination of the upper gastrointestinal tract “including esophagus, stomach, and either the duodenum or jejunum as appropriate,” includes the use of endoscopic ultrasonography, the service is reported by a single code, namely CPT 43259.

Interpretation, whether by a radiologist or endoscopist, is reported under CPT code 76975-26. These codes may both be reported on the same day.

Description Of CPT Codes

Report only a single EUS Code per session. 

CPT 43231

Description Of CPT 43231: Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination.

Esophagogastroduodenoscopy (EGD) Component: Esophagus only
Ultrasound Component: Esophagus only
FNA/Biopsy: None

CPT 43232

Description Of CPT 43232: Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s).

Esophagogastroduodenoscopy (EGD) Component: Esophagus only
Ultrasound Component: Esophagus only
FNA/Biopsy: Esophagus only

CPT 43237

Description Of CPT 43237: Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures.

Esophagogastroduodenoscopy (EGD) Component: Esophagus, stomach, other organs
Ultrasound Component: Esophagus only
FNA/Biopsy: None

CPT 43238

Description Of CPT 43238: Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures).

Esophagogastroduodenoscopy (EGD) Component: Esophagus, stomach, other organs
Ultrasound Component: Esophagus only
FNA/Biopsy: Esophagus only

CPT 43242

Description Of CPT 43242: Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis).

Esophagogastroduodenoscopy (EGD) Component: Esophagus, stomach, other organs
Ultrasound Component: Esophagus, stomach,  other organs
FNA/Biopsy: Esophagus, stomach, other organs

CPT 43259: 

Description Of CPT 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.

Esophagogastroduodenoscopy (EGD) Component: Esophagus, stomach, other organs
Ultrasound Component: Esophagus, stomach, other organs
FNA/Biopsy: None