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GI coding

Does code 43239 include transendoscopic ultrasound-guided intramural or transmural fine needle aspiration biopsy including endoscopic ultrasound examination of the esophagus, stomach and duodenum? The way the CPT code book states this code, it appears that it includes the transendoscopic US guided fine needles aspiration/biopsy and other biopsies single or multiple.
If so, then why is it OK to bill 43242 at the same operative session? And if it wasn’t billed with modifier 59 it should not be payable?
What is the difference?

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