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.
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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.
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RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
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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
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Modifiers provide additional information about the service provided.
Detail About CPT 43250
Related Codes Table
| CPT Code | Description |
|---|---|
| 43251 | Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube |
| 43255 | Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus (bougie or balloon) |
| 43259 | Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) |
| 43270 | Esophagoscopy, rigid or flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed |
| 43276 | Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery |
Commonly Billed With
CPT 43250 is commonly billed with anesthesia services (e.g., CPT codes 00731, 00810) and pathology services (e.g., CPT codes 88305, 88307).
Clinical Scenarios
Scenario 1: Removal of Esophageal Polyp
A patient undergoes an esophagogastroduodenoscopy for the removal of an esophageal polyp using hot biopsy forceps.
Scenario 2: Biopsy of Gastric Lesion
A physician performs an esophagogastroduodenoscopy to biopsy a suspicious lesion in the gastric region using bipolar cautery.
Scenario 3: Treatment of Esophageal Tumor
An esophagogastroduodenoscopy is performed to remove a tumor in the esophagus utilizing hot biopsy forceps.
FAQ
Can CPT 43250 be reported separately from the pathology services?
No, CPT 43250 includes the removal of tumors, polyps, or lesions and does not require separate reporting for pathology services.
Is anesthesia bundled with CPT 43250?
No, anesthesia services are typically reported separately using appropriate anesthesia CPT codes when provided during the procedure.
What is the difference between hot biopsy forceps and bipolar cautery?
Hot biopsy forceps use heat to grasp and remove tissue samples while bipolar cautery uses electrical energy to coagulate tissue and control bleeding.
Can CPT 43250 be used for both diagnostic and therapeutic procedures?
Yes, CPT 43250 can be used for both diagnostic (e.g., biopsy) and therapeutic (e.g., lesion removal) procedures involving the upper gastrointestinal tract.
h4>Are there specific documentation requirements for reporting CPT code 43250?
Physicians must document the indication for the procedure, findings, techniques used (hot biopsy forceps or bipolar cautery), and any complications encountered during the esophagogastroduodenoscopy procedure.
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