Top 15 Proven Gastroenterology CPT Codes for Better Billing Results
Gastroenterology CPT Codes help providers, coders, and billing teams document GI procedures for reimbursement. Each code represents a specific service, whether it’s a diagnostic endoscopy, a biopsy, or a therapeutic colonoscopy. Correct coding reduces denials, improves claim approvals, and supports consistent billing. In this blog, you’ll find 15 proven CPT codes every gastroenterology practice should know for better billing results.
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Here are the 15 proven Gastroenterology CPT codes
These codes cover a wide range of services, from diagnostic endoscopies to advanced therapeutic procedures. By applying them correctly, providers reduce billing errors, improve claim approvals, and maintain compliance. Let’s look at each code in detail:
1. 43235 – Diagnostic Esophagogastroduodenoscopy (EGD)
A diagnostic EGD allows physicians to examine the esophagus, stomach, and duodenum. It is one of the most frequently billed Gastroenterology CPT Codes, especially when no biopsy or intervention is performed.
2. 43239 – EGD with Biopsy
This CPT code is used when tissue samples are taken during an upper GI endoscopy. Because biopsy results drive diagnosis, payers often review this Gastroenterology CPT Codes entry closely during claims.
“A biopsy may be tiny, but in billing, even small codes pack a big punch!”
3. 43251 – EGD with Polyp or Lesion Removal (Snare Technique)
When a lesion or polyp is removed during an EGD using a snare, 43251 is applied. Compared to a standard scope, this is another widely used Gastroenterology CPT Codes reference for billing.
4. 43274 – ERCP with Stent Placement
Used for ERCP procedures where a stent is inserted into the bile or pancreatic ducts. As a result, this is one of the Gastroenterology CPT Codes that reflect therapeutic interventions to relieve obstruction.
5. 43260 – ERCP Diagnostic
This code applies when ERCP is performed solely for diagnostic purposes, without stent placement or other therapy. It belongs to the category of Gastroenterology CPT Codes that highlight evaluation-based services.
6. 43259 – Endoscopic Ultrasound (EUS)
EUS combines endoscopy and ultrasound imaging to evaluate the layers of the GI tract wall. Many blogs on Gastroenterology CPT Codes list 43259 as a must-know billing code for GI practices.
7. 43246 – Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement
PEG placement is billed under 43246 and is used for patients needing long-term feeding access. This procedure is consistently reported in Gastroenterology CPT Codes manuals.
8. 45378 – Diagnostic Colonoscopy
The most widely used lower GI procedure code, applied for screening or diagnostic colonoscopy when no biopsy or therapeutic action occurs.
9. 45380 – Colonoscopy with Biopsy
When tissue samples are collected during colonoscopy, this code applies. It is among the most common colonoscopy billing codes in the Gastroenterology CPT Codes framework.
10. 45381 – Colonoscopy with Directed Submucosal Injection
CPT 45381 applies when dye or medication is injected into the colon wall. Among Gastroenterology CPT Codes, it is used to mark tissue for surgery or deliver targeted treatment during colonoscopy.
11. 45385 – Colonoscopy with Polypectomy (Snare Removal)
This code reports removal of polyps using a snare. It is one of the most frequently billed Gastroenterology CPT Codes, vital for preventive care and reimbursement in GI practices.
12. 45388 – Colonoscopy with Ablation of Tumor or Polyp
CPT 45388 covers tissue removal by cautery or laser. Within Gastroenterology CPT Codes, it identifies advanced therapeutic work performed during colonoscopy.
13. 45390 – Colonoscopy with Endoscopic Mucosal Resection (EMR)
This code applies when larger lesions are removed endoscopically. As part of Gastroenterology CPT Codes, it reflects complex yet minimally invasive colonoscopy billing.
14. 91110 – Capsule Endoscopy (Small Intestine)
CPT 91110 is billed when a capsule camera records small intestine images. Listed under Gastroenterology CPT Codes, it supports non-invasive diagnostic billing.
15. 91010 – Esophageal Manometry (Motility Study)
CPT 91010 measures muscle contractions and pressure in the esophagus. It is vital for diagnosing motility disorders like achalasia and regularly featured in Gastroenterology CPT Codes guides.
For additional insights into gastroenterology procedures and coding, check out this gastroenterology coding article.
Categories of Gastroenterology CPT Codes
Tips for Selecting the Right Gastroenterology CPT Codes
When applying Gastroenterology CPT Codes, keep these points in mind to achieve better billing results:
Review the procedure note → confirm if the service was diagnostic or therapeutic.
Check for additional steps → note whether a biopsy, polyp removal, or ablation was performed, as each requires a distinct CPT code.
Match CPT with ICD-10 → always link procedure codes with the correct diagnosis to prove medical necessity.
Apply modifiers correctly → use common ones like 26, TC, or 59 to clarify service details and prevent denials.
Stay updated with code changes → CPT codes are revised annually, so review updates to avoid outdated billing.
By following these tips, providers can use Gastroenterology CPT Codes more effectively, reduce claim errors, and achieve consistent billing outcomes.
“Coding isn’t rocket science, but one wrong digit can send your claim into orbit!”
If you are interested to read more about practical insights on Gastroenterology, please have a look at this case study on ‘‘How We Recovered 45% Revenue for a Gastroenterology Practice’’.
Correct use of Gastroenterology CPT Codes helps reduce claim denials, improve billing accuracy, and support steady reimbursements. These 15 proven codes give GI practices a reliable reference for better billing results.
👉 Need help with gastroenterology coding or billing support? Contact MBW RCM today to learn how our team can help your practice achieve a smoother billing outcome.
