CPT 43252: Esophagogastroduodenoscopy with Endomicroscopy
CPT code 43252 identifies an esophagogastroduodenoscopy (EGD) performed using an endomicroscopy system to evaluate the esophagus, stomach, and duodenum. This code captures advanced diagnostic endoscopy that augments standard visualization with microscopic-level assessment during the procedure. Nationally, such procedures are relevant for centers managing complex upper gastrointestinal disease, surveillance of premalignant conditions, and diagnostic clarification when high-resolution or targeted tissue assessment is needed.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the role of endomicroscopy in EGD. The publication outlines what practices and facilities should track for billing and documentation, common modifier usage (listed separately), and how this service aligns with procedural coding categories.
This summary also prepares readers to review benchmarks and policy-related items where available, and to understand procedural indications and operational considerations tied to CPT code 43252. Data not available in the input is noted where applicable in detailed sections.
Customize your policy alerts
Sign up for cpt 43252 policy alerts
Get alerted when payer policies referencing 43252 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 43252 describes an esophagogastroduodenoscopy performed with an endomicroscopy system. The procedure uses a flexible endoscope passed through the mouth to visualize the esophagus, stomach, and duodenum, with endomicroscopy providing real-time microscopic evaluation of mucosal structures during the endoscopic examination.
Service Type: Diagnostic endoscopic procedure with endomicroscopy
Typical Site of Service: Hospital outpatient department or ambulatory endoscopy center, with occasional performance in physician office settings equipped for advanced endoscopy.