Esophagoscopy – CPT Codes 43191

©
ASGE LOGO
©
2014
CPT
Changes - Gastroenterology
2014 Information
Esophagoscopy
CPT
Changes
AND INFO
Technology Solutions
Esophagoscopy – CPT Codes 43191 - 43234
The American Society for Gastrointestinal Endoscopy (ASGE), American Gastroenterological Association (AGA) and
American College of Gastroenterology (ACG) work closely together to ensure that adequate methods are in place for
gastroenterology practices to report and obtain fair and reasonable reimbursement for procedures, tests and visits. 2013 marked
a year of many changes to the Current Procedural Terminology (CPT) for gastroenterology services. In order to assist practices
in understanding and implementing the revised and new codes, ASGE has developed coding sheets. The purpose of the coding
sheets is to provide a high level overview of the changes to support practices as they prepare for 2014.
What is an Esophagoscopy?
It is the examination of the interior of the
esophagus by means of an esophagoscope.
The CPT© codes in this series identify
services performed during an
esophagoscopy. They are broken down by
scope type – Flexible, Rigid and the
different approaches – Transoral or
Transnasal.
Overview of CPT© Changes for 2014
Revisions to Esophagoscopy code series include:
•
Updating CPT© codes for consistency with changes made to the base codes for Rigid Esophagoscopy and
Flexible Esophagoscopy;
•
Addition of revised guidelines to address control of bleeding and define Esophagoscopy;
•
Modification to Flexible Esphagoscopy stent and ablation CPT codes;
•
14 new codes, renumbering of several existing codes and the deletion of four codes;
•
Updating and clarification of imaging guidance and additional parentheticals.
CPT Only ©2013 American Medical Association. All rights reserved
2014 Esophagoscopy CPT© Codes
KEY =
• = New Code
▲ = Revised Code = Moderate Sedation # = Resequenced Code
Change Detail
©
CPT Code
Code Descriptor
2013 to 2014
Esophagoscopy, Rigid
43191
Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or
washing when performed
New Code
For flexible, use 43200
For transnasal, use 43197
43192
with directed submucosal injection(s), any substance
New Code
For flexible, use 43201
43193
with biopsy, single or multiple
New Code
For flexible, use 43202
For transnasal, use 43198
43194
with removal of foreign body
New Code
For flexible, use 43215
43195
with balloon dilation (less than 30 mm diameter)
New Code
For flexible, use 43220
43196
with insertion of guide wire followed by dilation over guide wire
New Code
For flexible, use 43226
Esophagoscopy, Flexible, Transnasal
43197
Esophagoscopy, flexible, transnasal; diagnostic, includes collection of specimen(s) by
brushing or washing, when performed
New Code
For rigid transoral, use 43191
For flexible transoral, use 43200
43198
with biopsy, single or multiple
New Code
For rigid transoral, use 43193
For flexible transoral, use 43202
Esophagoscopy, Flexible, Transoral
43200
43201
Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or
washing, when performed
For rigid, use 43191
with directed submucosal injection(s), any substance
Parent code revised
For transnasal, use 43197
For rigid, use 43192
43202
with biopsy, single or multiple
Parent code revised
For rigid, use 43193
For transnasal, use 43198
43204
with injection sclerosis of esophageal varices
Parent code revised
For rigid, use 43499
2014 RVU
Value
43205
with band ligation of esophageal varices
Parent code revised
43206
with optical endomicroscopy
Parent code revised
43215
with removal of foreign body
Parent code revised
For rigid, use 43194
43216
with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
Parent code revised
43217
with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Parent code revised
#
43211
with endoscopic mucosal resection
New code
#
43212
with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when
performed)
New code
43219
with insertion of plastic tube or stent
Deleted 43219
Use 43212
43220
with transendoscopic balloon dilation (less than 30 mm diameter)
Parent code revised
For rigid, use 43195
#
43213
with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when
performed)
New code
#
43214
with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance,
when performed)
New code
43226
with insertion of guide wire followed by passage of dilator(s) over guide wire
Parent code revised
For rigid, use 43196
43227
with control of bleeding, any method
Parent code revised
Terminology reconciliation with
43255
with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy
forceps, bipolar cautery or snare technique
Deleted 43228
with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire
passage, when performed)
New Code
43231
with endoscopic ultrasound examination
Parent code revised
43232
with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)
Parent code revised
43234
Upper gastrointestinal endoscopy, simple primary examination (eg, with small diameter flexible
endoscope) (separate procedure);
Deleted 43234
43228
43229
Use 43229
Includes balloon dilation, insertion
of guide wire, and ablation
described by 43220, 43226, 43228
See 43197, 43200, 43235