2025 CPT code 43247
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Digestive System - Endoscopy Procedures on the Esophagus Surgery Feed
Esophagogastroduodenoscopy (EGD) with removal of a foreign body.
Modifiers 22 (increased procedural service), 51 (multiple procedures), 52 (reduced services), and 53 (discontinued procedure) may be applicable depending on specific circumstances of the procedure.
Medical necessity for 43247 is established when a foreign body is present in the upper gastrointestinal tract causing symptoms or potential complications requiring endoscopic removal.Imaging studies may support the necessity but are not always required.
The physician inserts the endoscope, examines the esophagus, stomach, and duodenum (if applicable), identifies and removes the foreign body using appropriate instruments passed through the endoscope’s working channel, and ensures proper patient monitoring and post-procedure care.
- Surgery
- Surgery > Surgical Procedures on the Digestive System > Surgical Procedures on the Esophagus > Endoscopy Procedures on the Esophagus
In simple words: The doctor uses a thin, flexible tube with a camera and light (endoscope) to examine your esophagus, stomach, and the beginning of your small intestine.They will remove any foreign object found in these areas.
This CPT code represents an esophagogastroduodenoscopy (EGD) procedure, utilizing a flexible endoscope inserted transorally, to examine the esophagus, stomach, and duodenum.The procedure includes the removal of a foreign body from the upper gastrointestinal tract.The duodenum may or may not be examined depending on clinical necessity.If the duodenum is not examined, modifier 52 (reduced services) or 53 (discontinued procedure) may be appended depending on whether a repeat examination is planned.
Example 1: A patient presents after accidentally swallowing a coin.EGD is performed to locate and remove the coin. Code 43247 is appropriate., A child swallows a small toy.An EGD is performed to retrieve the toy; however, due to significant gastric retention, the duodenum is not examined.Code 43247 with modifier 52 is reported., A patient presents with esophageal obstruction from an ingested piece of bone.The EGD is performed, the bone fragment removed, and the duodenum is examined for any other potential issues. Code 43247 is reported.
Complete patient history including the nature of the foreign body, symptoms, and imaging (if performed).Detailed operative report including the type and location of the foreign body, techniques used for removal, and any complications.Anesthesia records.Post-operative recovery notes.Final pathology report, if applicable.
** Accurate documentation is crucial for proper coding and reimbursement.Always refer to the most current CPT manual and payer-specific guidelines for precise coding and billing practices.
- Revenue Code: P8B (ENDOSCOPY - UPPER GASTROINTESTINAL)
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier might apply depending on the specific circumstances and the involvement of different providers.Check payer rules and guidelines.
- Specialties:Gastroenterology, General Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center