CPT Code Lookup Tool
Use this free CPT Lookup Tool to search for Current Procedural Terminology (CPT) codes, descriptions, and related details — designed to help streamline and simplify your medical billing process.
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Office or other outpatient visit
Evaluation and management of an established patient...
Information
This code is for use in medical billing and coding.
Information
This code is part of the section of CPT codes.
Office or other outpatient visit for the evaluation and management...
Note
This description reflects the 2021 E/M coding guidelines.
Information
codes are used to report evaluation and management services provided in various settings.
Information
RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
Information
This code is commonly used by primary care providers, but may be used by any specialty providing office visits.
Significant, separately identifiable E/M service
Information
Modifiers provide additional information about the service provided.
Detail About CPT 43237
Related Codes Table
| Code | Description |
|---|---|
| 43235 | Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed |
| 43236 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
| 43238 | Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus and stomach |
| 43240 | Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach, and duodenum |
Commonly Billed With
CPT code 43237 is commonly billed with:
- 43231 - Esophagoscopy, rigid or flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed
- 76975 - Ultrasound of gastroesophageal junction and/or upper gastrointestinal tract
Clinical Scenarios
Scenario 1: Diagnostic Procedure
In this scenario, CPT code 43237 is used for a diagnostic esophagogastroduodenoscopy with endoscopic ultrasound examination limited to specific areas.
Scenario 2: Biopsy Procedure
If during the procedure biopsies are taken from the esophagus, stomach, or duodenum in addition to the endoscopic ultrasound examination, additional codes may be reported.
Scenario 3: Follow-up Examination
CPT code 43237 may be used for follow-up examinations to assess treatment response or disease progression in patients with known esophageal, gastric, or duodenal conditions.
FAQs
Can CPT code 43237 be reported for screening purposes?
No, CPT code 43237 is not intended for screening purposes. It is typically used for diagnostic or therapeutic procedures.
Are there any age restrictions for reporting CPT code 43237?
There are no specific age restrictions associated with reporting CPT code 43237. The medical necessity of the procedure should be documented.
Is sedation included in the description of CPT code 43237?
No, sedation services are reported separately using appropriate anesthesia codes. The use of sedation should be clearly documented in the medical record.
Can modifier -59 be used with CPT code 43237?
Modifier -59 should only be used if the procedures are performed at different anatomic sites or separate encounters on the same date of service. It should be applied judiciously and supported by documentation.
What documentation is required to support billing CPT code 43237?
The documentation should include indications for the procedure, findings from the examination and ultrasound evaluation, any complications encountered, and the medical necessity for performing the procedure.
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