How To Use CPT Code 43194

CPT 43194 describes the procedure of rigid esophagoscopy with the removal of foreign bodies. 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 43194?

CPT 43194 can be used to describe the examination of the esophagus using a rigid esophagoscope, with the specific purpose of removing foreign bodies. The provider inserts the esophagoscope through the patient’s mouth and down the throat to the level of the esophagus. Once the foreign bodies are identified, they are removed using a grasping instrument inserted through the working channel of the scope.

2. Official Description

The official description of CPT code 43194 is: ‘Esophagoscopy, rigid, transoral; with removal of foreign body(s).’ It is important to note that CPT 43194 should not be reported in conjunction with codes 43191, 43197, or 43198. If fluoroscopic guidance is performed during the procedure, code 76000 should be used. For flexible transoral esophagoscopy with removal of foreign bodies, code 43215 should be used instead.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider inserts a rigid esophagoscope into the patient’s mouth and down the throat to the level of the esophagus.
3. The provider inspects the esophagus for foreign bodies.
4. If foreign bodies are identified, the provider removes them using a grasping instrument inserted through the working channel of the esophagoscope.
5. Once the foreign bodies are removed, the provider withdraws the esophagoscope and removes all instruments.

4. Qualifying circumstances

CPT 43194 is used when there is a need to examine the esophagus for foreign bodies and remove them. Foreign bodies can include objects such as pieces of meat or other foodstuffs that are too large to pass into the stomach. The procedure is performed transorally, meaning it is done through the mouth. It is important to note that CPT 43194 should not be reported in conjunction with codes 43191, 43197, or 43198.

5. When to use CPT code 43194

CPT code 43194 should be used when a provider performs a rigid esophagoscopy to examine the esophagus and remove foreign bodies. It is important to ensure that the procedure is performed transorally and that it is not reported with other specific codes mentioned earlier. If the procedure involves flexible esophagoscopy, code 43215 should be used instead.

6. Documentation requirements

To support a claim for CPT 43194, the provider must document the following information:

• Reason for the procedure and the need to remove foreign bodies
• Details of the procedure, including the use of a rigid esophagoscope
• Date and time of the procedure
• Description of the foreign bodies removed
• Any complications or additional procedures performed
• Provider’s signature

7. Billing guidelines

When billing for CPT 43194, ensure that the procedure is performed transorally using a rigid esophagoscope. It should not be reported in conjunction with codes 43191, 43197, or 43198. If fluoroscopic guidance is used during the procedure, code 76000 should be reported separately. It is important to note that for flexible esophagoscopy with removal of foreign bodies, code 43215 should be used instead.

8. Historical information

CPT 43194 was added to the Current Procedural Terminology system on January 1, 2014. The code has undergone a change on January 1, 2015, with the description being updated to specify the removal of foreign bodies.

9. Examples

1. A provider performs a rigid esophagoscopy to remove a fish bone lodged in a patient’s esophagus.
2. During a rigid esophagoscopy, a provider identifies and removes a piece of meat stuck in a patient’s esophagus.
3. A patient presents with difficulty swallowing, and a provider performs a rigid esophagoscopy to remove a foreign object causing the obstruction.
4. During a rigid esophagoscopy, a provider removes a coin that a child accidentally swallowed.
5. A patient complains of chest pain after swallowing a small battery, and a provider performs a rigid esophagoscopy to remove the foreign body.
6. A provider performs a rigid esophagoscopy to remove a dental prosthesis that became dislodged and stuck in a patient’s esophagus.
7. During a rigid esophagoscopy, a provider removes a piece of glass that a patient accidentally swallowed.
8. A child presents with persistent coughing, and a provider performs a rigid esophagoscopy to remove a small toy obstructing the airway.
9. A provider performs a rigid esophagoscopy to remove a button battery that a patient ingested.
10. During a rigid esophagoscopy, a provider removes a sharp bone fragment that a patient swallowed while eating.