CPT® Code 43755

1. Indications

The procedure described by CPT® Code 43755 is indicated for the evaluation of gastric secretory function in patients who may have conditions affecting gastric acid production or secretion. The following are specific indications for performing this procedure:

• Gastric Secretory Study This procedure is performed to assess the gastric secretory capacity, which may be necessary for diagnosing conditions such as peptic ulcers, gastritis, or Zollinger-Ellison syndrome.
• Evaluation of Gastric Disorders It is indicated for patients presenting with symptoms of gastric disorders, including unexplained abdominal pain, nausea, or vomiting, where gastric secretions may play a role in the clinical picture.
• Monitoring Treatment Efficacy The procedure may be used to monitor the effectiveness of treatments aimed at modifying gastric secretion, such as medications for acid reduction or stimulation.

2. Procedure

The procedure for CPT® Code 43755 involves several detailed steps to ensure accurate gastric intubation and specimen collection:

• Step 1: Patient Preparation The patient is prepared for the procedure, which includes explaining the process and obtaining informed consent. The patient may be positioned comfortably, typically in a semi-reclined position to facilitate tube insertion.
• Step 2: Selection of Nostril The physician examines both nostrils to determine which one is more patent. The selected nostril is then prepared for tube insertion.
• Step 3: Anesthesia Application Viscous lidocaine is instilled into the chosen nostril to provide local anesthesia, minimizing discomfort during the tube insertion.
• Step 4: Tube Measurement and Insertion The length of the gastric tube is estimated based on the distance from the nostril to the stomach, and the tube is marked accordingly. The tube is then inserted into the nostril and advanced through the nasopharynx.
• Step 5: Advancement of the Tube The patient may be instructed to sip water to assist in advancing the tube through the oropharynx and esophagus until it reaches the stomach.
• Step 6: Verification of Placement Proper placement of the tube is confirmed by instilling air into the stomach and auscultating for a rush of air or by aspirating gastric contents to ensure the tube is correctly positioned.
• Step 7: Diagnostic Aspiration Once the tube is confirmed to be in the correct position, the physician performs the diagnostic aspiration procedure, collecting multiple fractional specimens of gastric secretions for analysis.
• Step 8: Drug Administration During the procedure, specific drugs such as histamine, insulin, pentagastrin, calcium, and secretin are administered to stimulate gastric secretion, which is essential for the evaluation of gastric function.

3. Post-Procedure

After the completion of the procedure, the patient is monitored for any immediate adverse reactions to the drug administration or the procedure itself. The physician may provide instructions regarding post-procedure care, which could include dietary recommendations or restrictions based on the findings from the gastric secretory study. The patient may also be advised to report any unusual symptoms or discomfort following the procedure. Follow-up appointments may be scheduled to discuss the results of the gastric secretions analysis and any further management or treatment options that may be necessary based on the findings.