© Copyright 2025 American Medical Association. All rights reserved.
Esophagoscopy, as described by CPT® Code 43219, involves the use of either a rigid or flexible endoscope to visualize the esophagus. This procedure is specifically performed to insert a plastic tube or stent into the esophagus, primarily aimed at treating stenosis, which refers to the narrowing of the esophagus. The procedure begins with the introduction of the endoscope through the patient's mouth or nose, allowing the physician to navigate to the affected area of the esophagus. Once the endoscope reaches the site of stenosis, the physician may perform dilation if necessary to facilitate the placement of the tube or stent. Prior to the insertion, a separate esophagogram is conducted to assess the length of the stenosis and to check for any bronchoesophageal fistulas, which are abnormal connections between the bronchial tubes and the esophagus. The procedure also involves marking the upper and lower margins of the stenosis using fluoroscopic guidance, ensuring precise placement of the tube or stent. After selecting an appropriately sized device, it is introduced through the endoscope and positioned within the narrowed segment of the esophagus. If a stent is utilized, it is expanded to fit properly within the esophagus. Following the placement, additional radiographs are taken to confirm the correct positioning and expansion of the stent, ensuring that it effectively addresses the stenosis.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 43219 is indicated for the treatment of esophageal stenosis, which is characterized by the narrowing of the esophagus. This condition can lead to difficulties in swallowing and may require intervention to restore normal esophageal function. The procedure may also be indicated when there is a need to assess the presence of bronchoesophageal fistulas, which are abnormal connections that can complicate esophageal conditions.
The procedure begins with the patient being positioned appropriately to facilitate access to the esophagus. The physician selects either a rigid or flexible endoscope, which is then introduced through the mouth or nose. This endoscope is carefully advanced into the esophagus until it reaches the area of stenosis. Once the endoscope is in place, the physician may perform dilation of the stenotic area if necessary to allow for the insertion of a plastic tube or stent. Prior to the insertion, a separate esophagogram is conducted to determine the length of the stenosis and to check for any bronchoesophageal fistulas. This imaging study provides critical information that guides the procedure. After identifying the stenosis, the physician marks the upper and lower margins using fluoroscopic guidance, ensuring accurate placement of the device. External radiopaque markers are placed to assist in this process. Following this, an appropriately sized plastic tube or stent is selected based on the measurements obtained. The selected device is then introduced through the endoscope and positioned within the narrowed portion of the esophagus. If a stent is used, it is deployed, meaning it is expanded to fit securely within the esophagus. Finally, separate radiographs are obtained to evaluate the expansion of the stent and to confirm that it is properly positioned within the esophagus.
After the completion of the esophagoscopy and the placement of the tube or stent, the patient is monitored for any immediate complications. Post-procedure care may include observation for signs of esophageal perforation, bleeding, or infection. Patients may be advised on dietary modifications, such as starting with liquids and gradually progressing to solid foods, depending on the physician's recommendations. Follow-up appointments are typically scheduled to assess the effectiveness of the stent or tube placement and to monitor for any recurrence of stenosis or other complications. Additional imaging studies may be required to ensure the stent remains properly positioned and functional.
| Short Descr | ESOPHAGUS ENDOSCOPY | Medium Descr | ESPHGSC RGD/FLX W/INSJ PLSTC TUBE/STENT | Long Descr | Esophagoscopy, rigid or flexible; with insertion of plastic tube or stent | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special rules for multiple endoscopic procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. | CCS Clinical Classification | 70 - Upper gastrointestinal endoscopy, biopsy |
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| 2014-01-01 | Deleted | Code deleted, see 43212 |
| Pre-1990 | Added | Code added. |