An Esophagogastroduodenoscopy (EGD), also known as an upper GI endoscopy, is a procedure that allows physicians to examine the lining of the esophagus, stomach, and upper part of the small intestine. It is commonly performed to diagnose conditions such as acid reflux, ulcers, chronic abdominal pain, or gastrointestinal bleeding. For providers, ensuring that an EGD is billed under the correct CPT code is crucial to avoid claim denials and guarantee proper reimbursement.
The CPT code for an EGD depends on the specific service performed during the procedure:
Each of these codes reflects a different level of complexity. For example, a diagnostic-only EGD is coded as 43235, while performing a biopsy during the procedure requires using 43239.
Correct coding isn’t just about compliance—it directly impacts revenue. Using the wrong CPT code can result in:
Given the complexity of gastroenterology procedures, coding errors are common but preventable with the right expertise.How EZ Settle Solutions Can Help
At EZ Settle Solutions, we provide accurate and reliable billing support for gastroenterology practices. Our expert team specializes in:
With our support, providers can focus more on patient care while we handle the complexities of billing and coding.
For further reference, providers can also review the official AMA CPT® coding guidelines.
The correct CPT code for an EGD depends on the type of procedure performed—whether diagnostic, biopsy, dilation, bleeding control, or foreign body removal. Accurate coding ensures compliance, reduces claim rejections, and protects your revenue stream.
If your practice needs expert support, EZ Settle Solutions can help ensure accurate gastroenterology billing, faster reimbursements, and improved financial performance.