2025 CPT code 43251
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Esophagus Surgery Feed
Esophagogastroduodenoscopy with snare removal of lesion(s).
Modifiers 22, 51, 52, 53, 59, 76, 77, 78, 79, and others may be applicable depending on the circumstances of the procedure.
The medical necessity for 43251 is established by the presence of a lesion requiring removal.The lesion may be symptomatic (causing bleeding, pain, or obstruction) or detected incidentally during an unrelated procedure.Documentation should clearly support the need for removal of the lesion.
The physician is responsible for administering anesthesia (if applicable), inserting and manipulating the endoscope, identifying and removing lesions using the snare technique, and ensuring the patient's safety throughout the procedure. Post-procedure monitoring and follow-up care may also be part of the physician's responsibility.
In simple words: This code describes a procedure where a doctor uses a thin, flexible tube with a camera on the end (a scope) to look inside your esophagus (the tube that connects your mouth to your stomach), stomach, and the beginning of your small intestine. During this procedure, the doctor might remove any abnormal growths using a special tool.
This CPT code, 43251, represents an esophagogastroduodenoscopy (EGD), a procedure involving the insertion of a flexible endoscope through the mouth to visualize the esophagus, stomach, and duodenum.The procedure includes the removal of one or more lesions (tumors, polyps, or other abnormal tissue growths) using a snare technique. The snare, a wire loop, is used to encircle and excise the lesion(s), with a low-power current used to cut the stalk and coagulate surrounding blood vessels to minimize bleeding.The procedure may involve examination of the jejunum if clinically indicated.
Example 1: A patient presents with a suspected polyp in the stomach.An EGD is performed, and a polyp is identified and removed using a snare. Code 43251 is reported., A patient with a history of gastrointestinal bleeding undergoes an EGD. During the procedure, a bleeding lesion is identified in the esophagus and successfully removed with a snare. Code 43251 is reported., A patient with dysphagia (difficulty swallowing) undergoes an EGD which reveals a small esophageal tumor. The tumor is removed via snare technique during the procedure, and code 43251 is used.
* Pre-procedure diagnosis and indication for the procedure.* Detailed description of the procedure, including the number and location of lesions removed.* Histopathology report (if applicable).* Anesthesia records (if applicable).* Patient's vital signs and any complications encountered during or after the procedure.
** This code should only be used when a snare technique is used to remove the lesion(s).Other techniques may require different codes.
- Revenue Code: P8B (ENDOSCOPY - UPPER GASTROINTESTINAL)
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code since it encompasses the entire procedure.
- Specialties:Gastroenterology, Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)