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2025 CPT code 43244

Esophagogastroduodenoscopy (EGD) with band ligation of esophageal and/or gastric varices; a procedure using a flexible endoscope to place bands on enlarged blood vessels to prevent bleeding.

Follow all applicable CPT coding guidelines, including those related to endoscopy procedures and the use of modifiers to reflect the extent of the procedure (e.g., modifier 52 for reduced services if the duodenum is not examined).

Modifiers may be applied as appropriate, such as modifier 52 (reduced services), 53 (discontinued procedure), or 76 (repeat procedure),depending on the specific circumstances of the procedure.

Medical necessity for this procedure is established by the presence of esophageal or gastric varices with high risk of bleeding (e.g., large varices, history of previous bleeding). The procedure aims to prevent potentially life-threatening hemorrhage.

The physician is responsible for performing the esophagogastroduodenoscopy, identifying varices, and performing the band ligation. This requires expertise in endoscopy and management of bleeding disorders.Pre-procedural assessment, post-procedural monitoring, and appropriate follow-up care are also the physician's responsibility.

IMPORTANT:Refer to CPT codes 43197, 43198, 43200, 43201, 43202, 43204, 43205, 43206, 43211, 43212, 43213, 43214, 43215, 43216, 43217, 43220, 43226, 43227, 43229, 43231, 43232 for related esophagogastroscopy procedures.Use codes 43233, 43235-43259, 43266, 43270 for examination of a surgically altered stomach where the jejunum is examined distal to the anastomosis.

In simple words: A thin, flexible tube with a camera (endoscope) is inserted through the mouth to view the esophagus and stomach.If there are enlarged blood vessels (varices) that could bleed, tiny rubber bands are placed around them to stop the bleeding.

Esophagogastroduodenoscopy (EGD), flexible, transoral, with band ligation of esophageal and/or gastric varices.This procedure involves inserting a flexible endoscope through the mouth to visualize the esophagus, stomach, and duodenum. Enlarged blood vessels (varices) in the esophagus or stomach are identified, and small rubber bands are placed around them to constrict and eventually eliminate the varices, thereby preventing bleeding.The procedure is typically performed under moderate sedation or general anesthesia.

Example 1: A 55-year-old male with a history of cirrhosis presents with hematemesis.EGD reveals large esophageal varices.Band ligation is performed to control the bleeding., A 60-year-old female with portal hypertension undergoes EGD which reveals multiple gastric varices.Selective band ligation is performed to prevent future hemorrhage., A 48-year-old patient with a history of alcohol abuse and suspected varices undergoes EGD as part of a diagnostic workup for recurrent gastrointestinal bleeding.Multiple esophageal varices are found and successfully treated with band ligation.

* Detailed history and physical examination noting symptoms of upper GI bleed (hematemesis, melena).* Complete endoscopic report including location, size, and number of varices treated.* Number of bands placed.* Documentation of pre-procedure and post-procedure vital signs and assessment.* Confirmation of medical necessity, especially if the procedure is performed electively.

** Accurate coding requires detailed documentation of the procedure, including the number of varices treated, location, and the use of any additional techniques.Any complications should also be documented.

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