2025 CPT code 43249
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Esophagogastroduodenoscopy with transendoscopic balloon dilation of esophagus (30 mm diameter or larger).
Modifiers may be applicable in certain situations, such as reduced services (52), discontinued procedures (53), or multiple procedures (51). Refer to current CPT guidelines for modifier usage.
Medical necessity for this procedure must be established by documenting the patient's symptoms, such as dysphagia, and confirming the presence of an esophageal stricture through appropriate diagnostic testing.
The physician is responsible for administering anesthesia, inserting the endoscope, inspecting the relevant structures, performing the balloon dilation, and ensuring the patient's safety throughout the procedure.
In simple words: The doctor uses a thin, flexible tube with a camera and light to look inside your esophagus, stomach, and the first part of your small intestine. During the procedure, they also use a balloon to widen any narrowed areas in your esophagus.
This code describes a procedure where a flexible endoscope is inserted through the mouth, down the esophagus, through the stomach, and into the duodenum.The esophagus is then dilated using a balloon with a diameter of 30 mm or larger.This procedure is typically used to treat esophageal strictures (narrowing).
Example 1: A patient with difficulty swallowing due to a benign esophageal stricture undergoes EGD with balloon dilation to widen the narrowed area., A patient with eosinophilic esophagitis experiences food impaction and requires EGD with balloon dilation to relieve the obstruction., A patient who has undergone radiation therapy for esophageal cancer develops a stricture and needs EGD with balloon dilation to improve swallowing function.
Documentation should include the indication for the procedure, the size of the balloon used, the location of the stricture, and any complications encountered. Pre- and post-procedure assessments, including vital signs, should also be documented.
- Revenue Code: P8B
- Specialties:Gastroenterology
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient or Outpatient), Office