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BETA v.3.0

2025 CPT code 43252

Esophagogastroduodenoscopy (EGD) with optical endomicroscopy.

The supply of contrast agent should be reported separately.

Modifiers may be applicable to indicate specific circumstances (e.g., reduced services, discontinued procedure). Refer to current CPT guidelines for appropriate modifier usage.

Medical necessity for this procedure must be established by demonstrating a clinical need for the detailed microscopic imaging provided by optical endomicroscopy, such as evaluating suspicious lesions or assessing for specific conditions.

The physician administers anesthesia, inserts the endoscope and endomicroscope, navigates to the target areas, captures images, and removes the instruments after the procedure.

In simple words: An esophagogastroduodenoscopy (EGD) is a procedure where a thin, flexible tube with a camera is inserted through your mouth to view your esophagus, stomach, and the beginning of your small intestine. During this procedure, a special microscopic camera is used to get a closer look at the cells in these areas.

This procedure involves inserting a flexible endoscope transorally to examine the esophagus, stomach, and duodenum/jejunum. Optical endomicroscopy, using a specialized endomicroscope, provides high-resolution images of the mucosal surface and underlying tissue for detailed evaluation. This allows for real-time in vivo histological assessment.

Example 1: A patient with Barrett's esophagus undergoes an EGD with optical endomicroscopy to evaluate for dysplasia or early signs of cancer., A patient with chronic abdominal pain and suspected celiac disease has an EGD with optical endomicroscopy to visualize the small intestine and assess for mucosal abnormalities., During a routine EGD, a suspicious lesion is found, and optical endomicroscopy is used to further characterize the lesion and guide biopsy.

Documentation should include the indication for the procedure, findings from the optical endomicroscopy, and any biopsies taken. The report must also detail the areas examined (esophagus, stomach, duodenum/jejunum) and any complications encountered.

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