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BETA v.3.0

2025 CPT code 43192

Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance.

Control of bleeding during the same operative session is not reported separately.

Modifiers may be applicable. Common modifiers include 22 (Increased Procedural Services), 51 (Multiple Procedures), 52 (Reduced Services), 53 (Discontinued Procedure), 59 (Distinct Procedural Service), and others.

Medical necessity should be established by documenting the patient's diagnosis and symptoms, and explaining why the injection(s) are necessary.

The physician is responsible for preparing and anesthetizing the patient, inserting the rigid endoscope, inspecting the esophagus, performing the submucosal injections, and removing the instruments.

In simple words: A rigid viewing tube is inserted through your mouth into the esophagus. The doctor then injects medicine or other substances into the lining of the esophagus.

This code describes a procedure where a rigid endoscope is inserted through the mouth into the esophagus.The physician then injects a substance into the submucosal layer of the esophagus.This could be for various reasons such as injecting botulinum toxin, steroids, India ink to mark a lesion, or saline to lift a lesion.

Example 1: A patient with achalasia undergoes esophagoscopy with rigid endoscope and injection of botulinum toxin into the lower esophageal sphincter., A patient with a submucosal esophageal lesion undergoes esophagoscopy with rigid endoscope, and India ink is injected to mark the lesion for subsequent surgical removal., A patient with esophageal stricture undergoes esophagoscopy with a rigid endoscope, and steroid is injected into the stricture to reduce inflammation and improve swallowing.

Documentation should include the type of endoscope used (rigid), the approach (transoral), the substance injected, the location of the injection(s), and the reason for the injection(s).

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