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BETA v.3.0

2025 CPT code 43229

Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)

Follow current CPT coding guidelines for proper coding and billing.

Modifiers may be applicable.

Medical necessity for 43229 must be supported by documentation of a medically necessary indication for the procedure, such as the presence of a tumor, polyp, or other lesion in the esophagus requiring ablation.

Administering anesthesia, inserting and maneuvering the endoscope, performing the ablation, dilating the esophagus, and managing any complications.

IMPORTANT:Do not report 43229 in conjunction with 43220, 43226 for the same lesion. Do not report 43229 in conjunction with 43197, 43198, 43200. For esophagoscopic photodynamic therapy, report 43229 in conjunction with 96570, 96571 as appropriate.

In simple words: The doctor inserts a thin, flexible tube with a camera and light (endoscope) through your mouth and into your food pipe (esophagus). Using this tube, they destroy abnormal growths like tumors or polyps using heat, cold, or other methods. The procedure may also involve widening the esophagus using small balloons or other tools and using a guidewire to help position the instruments.

This code describes a procedure where a flexible endoscope is inserted through the mouth into the esophagus to ablate (destroy) one or more tumors, polyps, or other lesions. It includes pre- and post-dilation of the esophagus and guidewire passage, when performed.The procedure often involves passing a guidewire into the esophagus and then passing dilators over the guidewire to widen the esophagus. This may be done before and/or after the ablation of the lesion(s).

Example 1: A patient with a Barrett's esophagus and high-grade dysplasia undergoes an esophagoscopy with ablation of the dysplastic tissue using radiofrequency ablation., A patient with a small esophageal tumor undergoes an esophagoscopy with ablation of the tumor using snare electrocautery. The esophagus is dilated before and after the ablation to ensure adequate passage of the endoscope., A patient with multiple esophageal polyps undergoes an esophagoscopy. Several polyps are removed using forceps, and a larger polyp is ablated using argon plasma coagulation. A guidewire is used to assist with the ablation of the larger polyp.

Pre-procedure diagnosis, size and location of lesion(s), method of ablation, use of dilation and guidewire, any complications, and post-procedure findings.

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