© Copyright 2025 American Medical Association. All rights reserved.
Esophagogastroduodenoscopy (EGD) is a diagnostic procedure that involves the use of a flexible endoscope to visualize the upper gastrointestinal (GI) tract, which includes the esophagus, stomach, and duodenum. The procedure is enhanced by the incorporation of optical endomicroscopy, a technique that allows for in vivo visualization and characterization of mucosal tissue at a microscopic level. This advanced imaging capability enables the physician to observe histological details during the endoscopic examination, providing critical insights into the mucosal architecture and any pathophysiological processes occurring within the GI tract. The flexible endoscope is inserted transorally, meaning it is introduced through the mouth, and is carefully advanced through the esophagus into the stomach and duodenum. As the endoscope is gradually withdrawn, the physician can visualize the mucosal surfaces and identify any abnormalities that may be present. The procedure also involves the application of a contrast agent, which enhances the visualization of the mucosa during the endomicroscopy phase. A miniaturized endomicroscope, either integrated into the flexible endoscope or inserted through it, utilizes a blue laser light to scan the gastrointestinal mucosa from the surface down to the deepest layers. This technique allows for the collection of targeted biopsies from areas exhibiting microscopic changes, rather than relying on random tissue sampling. The ability to obtain instant histological information during the procedure is invaluable for immediate treatment decisions. Optical endomicroscopy is particularly useful in diagnosing and managing various upper and lower gastrointestinal tract diseases, including Barrett's esophagus, gastric cancer, colorectal neoplasia, celiac disease, Crohn's disease, and ulcerative colitis, thereby enhancing the overall effectiveness of the endoscopic examination.
© Copyright 2025 Coding Ahead. All rights reserved.
Esophagogastroduodenoscopy with optical endomicroscopy is indicated for a variety of conditions and symptoms that necessitate detailed examination of the upper gastrointestinal tract. The following are explicitly provided indications for this procedure:
The procedure of esophagogastroduodenoscopy with optical endomicroscopy involves several critical steps that ensure a comprehensive examination of the upper gastrointestinal tract. The following procedural steps are outlined:
After the esophagogastroduodenoscopy with optical endomicroscopy, patients may experience some mild discomfort or a sore throat, which typically resolves quickly. It is important for patients to follow any post-procedure instructions provided by the physician, which may include dietary restrictions or activity limitations. The physician will discuss the findings of the procedure and any necessary follow-up care, including the results of the biopsies taken during the examination. Patients should be monitored for any adverse reactions to sedation or complications from the procedure, although serious complications are rare. Overall, the procedure is designed to provide valuable diagnostic information while ensuring patient safety and comfort.
| Short Descr | EGD OPTICAL ENDOMICROSCOPY | Medium Descr | EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY | Long Descr | Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8B - Endoscopy - upper gastrointestinal | MUE | 1 | CCS Clinical Classification | 70 - Upper gastrointestinal endoscopy, biopsy |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | SG | Ambulatory surgical center (asc) facility service | GC | This service has been performed in part by a resident under the direction of a teaching physician | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2014-01-01 | Changed | Description Changed |
| 2013-01-01 | Added | Added |
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