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2025 CPT code 43210

Esophagogastroduodenoscopy (EGD) with partial or complete esophagogastric fundoplasty, including duodenoscopy when performed.

Consult the AMA's CPT manual and payer-specific guidelines for detailed coding instructions.

Modifiers may be applicable based on circumstances such as reduced services (52), discontinued procedure (53), or multiple procedures (51).Consult the CPT manual for detailed guidance on modifier use.

Medical necessity is determined based on the patient's symptoms, clinical findings, and the failure of conservative management of GERD.Documentation must support the need for surgical intervention to improve esophageal function and alleviate symptoms.

The physician performs the EGD, assesses the esophageal and gastric anatomy, and performs the fundoplasty using an endoscopic approach. This includes inserting and manipulating the endoscope, placing sutures, and ensuring adequate hemostasis.Post-procedural care and follow-up are also the responsibility of the physician.

IMPORTANT Do not report 43210 with 43180, 43191, 43197, 43200, 43235.For open abdominal (laparotomy) fundoplasty, use 43327. For fundoplasty with fundic patch (Thal-Nissen), use 43325. For open thoracic (thoracotomy) fundoplasty, use 43328.If duodenum is deliberately not examined, use modifier 52 (if no repeat exam planned) or 53 (if repeat exam planned).

In simple words: The doctor uses a thin, flexible tube with a camera and light (endoscope) to examine the esophagus, stomach, and part of the small intestine.They also perform a procedure to strengthen the valve between the stomach and esophagus to help prevent acid reflux.

This CPT code encompasses a flexible, transoral esophagogastroduodenoscopy (EGD) procedure incorporating a partial or complete esophagogastric fundoplasty.The procedure involves the endoscopic examination of the esophagus, stomach, and duodenum (when clinically indicated).Fundoplasty, a surgical technique, is performed to reinforce the lower esophageal sphincter, thereby mitigating gastroesophageal reflux disease (GERD).Duodenoscopy is included in the coding when performed as part of the procedure.

Example 1: A 55-year-old patient presents with persistent heartburn and GERD symptoms despite medication.An EGD with fundoplasty is performed to address the reflux., A 40-year-old patient with a history of hiatal hernia undergoes an EGD to assess the extent of the hernia and receive a partial fundoplasty to improve esophageal function., A 60-year-old patient with a prior failed anti-reflux surgery undergoes an EGD with a complete fundoplasty to correct persistent GERD.

* Pre-operative assessment including patient history, physical examination, and relevant diagnostic testing (e.g., upper endoscopy report, pH studies).* Intraoperative findings, including images and descriptions of the procedure, type and extent of fundoplasty performed.* Post-operative care plan, including follow-up instructions and any complications.* Documentation of medical necessity.

** This code is specifically for the transoral endoscopic fundoplasty.Different codes apply to open surgical approaches.

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