CPT® Code 43757

Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration

The CPT® Code 43757 refers to a diagnostic procedure known as duodenal intubation and aspiration, which involves the insertion of a gastric tube through the nose or mouth to collect specimens from the duodenum. This procedure is performed using image guidance to ensure accurate placement of the tube into the duodenum. The process begins with the selection of the more patent nostril for tube insertion, followed by the administration of local anesthesia using viscous lidocaine to minimize discomfort. The length of the tube required for proper insertion is estimated and marked accordingly. The tube is then carefully advanced through the nasal passages, oropharynx, esophagus, and into the stomach, ultimately reaching the duodenum. During this procedure, the patient may be asked to sip water to facilitate the advancement of the tube. Once the tube is correctly positioned in the duodenum, multiple fractional specimens are collected for analysis, which is essential for evaluating duodenal content as well as pancreatic and gallbladder secretions. This procedure also includes the administration of specific drugs that stimulate the secretion of bile salts from the pancreas and gallbladder, enhancing the diagnostic yield of the specimens collected.