2025 CPT code 43756
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Duodenal Procedures Digestive System Feed
Duodenal intubation with aspiration of a single specimen for diagnostic purposes, utilizing image guidance.
Modifiers may be applicable depending on the circumstances of the procedure.Consult current coding guidelines to determine the appropriate modifiers.
Medical necessity for 43756 is established when clinical symptoms or findings suggest a condition that requires diagnostic evaluation of the duodenal contents.This may include conditions such as suspected gallstones, SIBO, or malabsorption syndromes. Appropriate documentation must support the medical necessity for the procedure.
The physician is responsible for proper patient preparation, anesthesia administration (if applicable), inserting the tube into the duodenum using image guidance, administering the stimulant, aspirating the duodenal contents, processing the sample for laboratory analysis, removing the tube, and verifying the absence of any injury during the process.
In simple words: The doctor inserts a thin tube into the small intestine (duodenum) using imaging to guide the placement.A substance is given to stimulate stomach acid production.Fluid is then collected through the tube for testing in a lab to help diagnose a problem.
This CPT code, 43756, represents the performance of duodenal intubation and aspiration of a single specimen (e.g., bile study for crystals or afferent loop culture) for diagnostic purposes. The procedure involves inserting a tube into the duodenum under image guidance (typically fluoroscopy), administering a stimulant (such as gastrin) intravenously to stimulate acid production in the stomach, aspirating duodenal contents via the tube, and sending the specimen for laboratory analysis.The procedure concludes with tube removal and verification of the absence of injury.
Example 1: A patient presents with suspected gallstones (cholelithiasis).A bile study is performed via duodenal intubation and aspiration to analyze the bile for the presence of crystals., A patient presents with symptoms suggestive of small intestinal bacterial overgrowth (SIBO). A duodenal aspirate is collected for bacterial culture and analysis., A patient with suspected malabsorption syndrome undergoes duodenal intubation to assess for abnormalities in the absorption of nutrients.
* Pre-procedure patient assessment and consent.* Documentation of the type of imaging guidance used.* Detailed description of the procedure performed, including the type and amount of stimulant administered.* Description of the specimen obtained, including volume and appearance.* Results of the laboratory analysis of the specimen.* Post-procedure assessment of the patient.* Documentation of any complications encountered.
** Always verify the specific requirements of the individual payer before billing.
- Revenue Code: P5E (Ambulatory Procedures - Other)
- RVU: RVU data not found in the source. Consult your local payer's fee schedule for accurate RVU values.
- Global Days : Global period information is not provided in the source.The global period for this procedure would depend on payer-specific guidelines and may vary.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier to 43756 is determined by payer-specific guidelines and may vary based on the clinical setting.
- Fee Schedule : Historical fee schedule data is not included in the provided sources. Check your local payer's fee schedule for historical payment information.
- Specialties:Gastroenterology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center