May 2007 page 10a
Coding Communication:Surgery: Digestive System
Question
The patient had an upper gastrointestinal
endoscopy (43234) without the
administration of moderate (conscious) sedation.
Because the moderate sedation symbol is
listed with this code in CPT 2007, should modifier
52, Reduced services, be appended to the
procedure code?
AMA Comment
No. Code 43234 is used to report an
upper gastrointestinal endoscopy, simple primary
examination, using a small diameter flexible
endoscope that is swallowed by the patient.
As stated in Appendix G of the CPT codebook,
in circumstances where a procedure listed in
Appendix G (Moderate [Conscious] Sedation)
and the...
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