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Esophagogastric tamponade, commonly referred to as balloon tamponade, is a medical procedure designed to provide temporary relief from bleeding caused by varices in the esophagus or stomach. This technique is particularly utilized in emergency situations where patients present with significant hemorrhage due to ruptured varices, which are dilated veins that can occur in conditions such as portal hypertension. The procedure involves the insertion of a specialized tube equipped with balloons that, when inflated, apply direct pressure to the bleeding vessels. This pressure helps to compress the varices, effectively controlling the hemorrhage and stabilizing the patient until further definitive treatment can be administered. During the procedure, the patient is intubated to ensure airway protection, allowing for safe management of the airway while the tamponade is performed. The process requires careful monitoring and adjustment of the balloon pressures to ensure optimal effectiveness while minimizing potential complications. Overall, esophagogastric tamponade serves as a critical intervention in the management of acute gastrointestinal bleeding, providing a bridge to more permanent therapeutic options.
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Esophagogastric tamponade is indicated for patients experiencing significant bleeding from gastric or esophageal varices. The following conditions may warrant the use of this procedure:
The esophagogastric tamponade procedure involves several critical steps to ensure effective management of bleeding varices:
After the esophagogastric tamponade procedure, careful monitoring is essential to assess the effectiveness of the tamponade and to detect any potential complications. The patient should be observed for signs of continued bleeding, and the pressures within the balloons should be regularly checked to ensure they remain at optimal levels. Additionally, healthcare providers must be vigilant for any adverse effects related to the procedure, such as esophageal or gastric injury. The patient may require further interventions or definitive treatments based on their clinical status and response to the tamponade. Documentation of the procedure, including the pressures used and the patient's response, is crucial for ongoing care and management.
| Short Descr | PRESSURE TREATMENT ESOPHAGUS | Medium Descr | ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE | Long Descr | Esophagogastric tamponade, with balloon (Sengstaken type) | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple 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. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 69 - Esophageal dilatation |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | CA | Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition |
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| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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