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43239 EGD with biopsy, single or multiple

Susquehanna Valley Posted Fri 27th of February, 2015 10:32:25 AM


My question is I do know that this code says "multiple". But what if the biopsy was from a different sites.

The physician took a biopsy from the antrum portion of the stomach, as well as a biopsy from the GE junction near the esophagus.

So this is multiple biopsies, but it is not MULTIPLE BIOPSIES FROM THE SAME SITE.

Please advise.

But I also did a lot of research. Can you point me to someplace that has this information in writing.


SuperCoder Answered Sun 01st of March, 2015 23:47:45 PM

Thanks for your question. The EDG codes are chosen by method. For instance if a provider removes a polyp or takes multiple biopsies using a snare then the code assignment would be 43251 no matter how many specimens were taken. The site in this case would not apply. The code description for 43239 includes single or multiple biopsies. The same would apply if the provider biopsied several sites using biopsy forceps, no matter the number of biopsies the code would be 43239. A difference would come in if the provider used multiple methods on multiple sites. For instance, a gastric polyp removed using snare technique (43251) and esophageal biopsy was taken (43239). Hope this helps.

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