Diagnostic and Therapeutic Esophagogastroduodenoscopy
J9 · Effective Oct 1, 2015
8 active Medicare policies list 43254, and 4 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J9 · Effective Oct 1, 2015
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J9 · Effective Oct 1, 2025
JL · Effective Oct 1, 2025
National · Effective Oct 1, 2025
4 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 43254 |
|---|---|---|
| Cigna Commercial Gastroenterology Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 43254 |
|---|---|---|
| Upper Gastrointestinal Endoscopy in Adults | Jul 1, 2026 | Covered |
| Policy | Effective | Status of 43254 |
|---|
| Upper Gastrointestinal Endoscopy (Esophagogastroduodenoscopy) | Apr 4, 2026 | Covered |
|---|