2025 CPT code 43290
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon.
Modifiers may be applicable in specific circumstances, such as if the procedure is discontinued (modifier 53) or significantly more extensive than usual (modifier 22).
Medical necessity for this procedure is established by documenting the patient's BMI, failed attempts at weight loss with less invasive methods, and the presence of comorbidities related to obesity.Specific payer requirements should be consulted.
The physician is responsible for prepping and anesthetizing the patient, inserting the endoscope, navigating it to the stomach, deploying and filling the balloon, and removing the scope.They must also monitor the patient during the procedure.
In simple words: A doctor inserts a thin, flexible tube with a camera through your mouth and into your stomach.Using this tube, they place a deflated balloon into your stomach and fill it with saline solution. The balloon helps you lose weight by taking up space in your stomach.
This code describes a procedure where a flexible endoscope is inserted through the patient's mouth to place an intragastric bariatric balloon in the stomach to aid in weight loss. The balloon is typically filled with saline solution after placement.
Example 1: A patient with a BMI of 35 and difficulty losing weight despite diet and exercise undergoes intragastric balloon placement., A patient preparing for bariatric surgery has a balloon placed as a bridge to surgery to facilitate weight loss pre-operatively., A patient who has previously had bariatric surgery but has regained weight may be a candidate for intragastric balloon placement, provided the surgical anatomy allows safe passage of the endoscope.
Documentation should include the pre-procedure evaluation, informed consent, operative report detailing the procedure, type of balloon used, amount of saline instilled, and any complications encountered. Post-procedure instructions and follow-up plan should also be documented.
** This is a relatively new procedure and coverage policies may vary between payers. It is important to check with the individual payer for specific requirements.
- Specialties:Gastroenterology, Bariatric Surgery
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Office