CPT® Code 43259

Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis

The procedure described by CPT® Code 43259 is an esophagogastroduodenoscopy (EGD) performed using a flexible, transoral approach, which involves the use of an endoscope to visualize the upper gastrointestinal tract. This procedure includes an endoscopic ultrasound examination that encompasses the esophagus, stomach, and either the duodenum or a surgically altered stomach, specifically when the jejunum is examined distal to the anastomosis. The process begins with the administration of an anesthetic spray to numb the mouth and throat, facilitating the insertion of a hollow mouthpiece. A flexible fiberoptic endoscope is then introduced and advanced through the esophagus into the stomach, allowing for direct visualization of the mucosal surfaces. The endoscope is carefully maneuvered to inspect various anatomical regions, including the cardia, fundus, greater and lesser curvature, and antrum of the stomach, as well as the duodenum or jejunum, depending on the patient's surgical history. Following the initial examination, an echoendoscope is utilized to perform an ultrasound evaluation of any identified abnormalities or lesions, providing critical information regarding their nature—whether intrinsic or extrinsic to the gastrointestinal tract. This comprehensive assessment aids in determining the extent of any lesions and their potential involvement with surrounding structures, which is essential for accurate diagnosis and treatment planning.