2025 CPT code 43220
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)
Modifiers may be applicable. Common modifiers include 22 (Increased Procedural Services), 52 (Reduced Services), 53 (Discontinued Procedure), and 59 (Distinct Procedural Service).
Medical necessity must be established by documenting the patient’s symptoms, such as dysphagia, and confirming the presence of an esophageal stricture through appropriate diagnostic testing.
In simple words: A flexible tube with a camera is inserted through your mouth to view your esophagus. A small balloon is then used to widen any narrow areas.
This code describes a procedure where a flexible endoscope is inserted through the mouth into the esophagus. The physician then uses a balloon (less than 30 mm in diameter) to dilate the esophagus.
Example 1: A patient presents with dysphagia due to a benign esophageal stricture. A flexible esophagoscopy with balloon dilation (less than 30 mm diameter) is performed to alleviate the stricture., Following corrosive ingestion, a patient develops an esophageal stricture. The physician performs a flexible esophagoscopy with balloon dilation (less than 30 mm diameter) to restore esophageal patency., A patient with eosinophilic esophagitis experiences difficulty swallowing.The physician performs a flexible esophagoscopy with balloon dilation (less than 30 mm) to dilate the narrowed esophagus.
Documentation should include the reason for the procedure, the size of the balloon used, the location and nature of the stricture, and any complications encountered.
- Specialties:Gastroenterology, Thoracic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Office