How To Use CPT Code 43191

CPT 43191 describes the procedure of esophagoscopy, which involves the use of a rigid endoscope to view the esophagus. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43191?

CPT 43191 is a code used to describe the procedure of esophagoscopy. This procedure involves the insertion of a rigid endoscope through the mouth to examine the esophagus. It may also include the collection of specimen(s) by brushing or washing when necessary. It is important to note that CPT 43191 should not be reported in conjunction with certain other codes, as specified in the notes.

2. Official Description

The official description of CPT code 43191 is: ‘Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure).’ This code should not be reported with specific other codes, as indicated in the notes.

3. Procedure

1. After administering anesthesia, the healthcare provider inserts a rigid endoscope through the patient’s mouth and down the throat to the level of the esophagus.
2. The provider carefully inspects the esophagus and visualizes the submucosal area.
3. If necessary, the provider may collect specimens by brushing or washing the area for further diagnostic analysis.

4. Qualifying circumstances

CPT 43191 is used for diagnostic purposes when a rigid endoscope is used to examine the esophagus. It may also include the collection of specimens by brushing or washing. It is important to note that this code should not be reported with certain other specified codes.

5. When to use CPT code 43191

CPT code 43191 should be used when a healthcare provider performs a diagnostic esophagoscopy using a rigid endoscope. This code is appropriate when the provider needs to visualize the esophagus and may collect specimens by brushing or washing. It is important to review the notes to ensure that this code is not reported in conjunction with specific other codes.

6. Documentation requirements

To support a claim for CPT 43191, the healthcare provider must document the following information:

• The need for the esophagoscopy procedure
• Details of the procedure, including the use of a rigid endoscope
• Date and duration of the procedure
• Any specimens collected by brushing or washing, if applicable
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43191, ensure that the procedure involves the use of a rigid endoscope for diagnostic purposes. Review the notes to determine if there are any specific codes that should not be reported in conjunction with CPT 43191. Adhere to the appropriate guidelines for reporting this code and consider any additional documentation requirements from the payer.

8. Historical information

CPT 43191 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates or changes to the code since its addition.

9. Examples

1. A gastroenterologist performs a diagnostic esophagoscopy using a rigid endoscope to examine a patient’s esophagus for any abnormalities.
2. A pathologist collects specimens by brushing and washing during a diagnostic esophagoscopy performed by an otolaryngologist.
3. An oncologist uses a rigid endoscope to visualize the esophagus and collect specimens for further analysis during a diagnostic procedure.
4. A surgeon performs a diagnostic esophagoscopy using a rigid endoscope to assess the extent of damage in a patient with suspected esophageal injury.
5. A gastroenterologist performs a diagnostic esophagoscopy with specimen collection by brushing and washing to investigate the cause of persistent acid reflux in a patient.
6. A pulmonologist uses a rigid endoscope to examine the esophagus and collect specimens for analysis during a diagnostic procedure for a patient with suspected aspiration pneumonia.
7. An otolaryngologist performs a diagnostic esophagoscopy using a rigid endoscope to evaluate a patient with difficulty swallowing.
8. A pathologist collects specimens by brushing and washing during a diagnostic esophagoscopy performed by a gastroenterologist to investigate the cause of gastrointestinal bleeding.
9. A surgeon uses a rigid endoscope to visualize the esophagus and collect specimens for analysis during a diagnostic procedure for a patient with suspected esophageal cancer.
10. An oncologist performs a diagnostic esophagoscopy with specimen collection by brushing and washing to assess the progression of a patient’s esophageal disease.