How To Use CPT Code 43217

CPT 43217 describes the procedure of esophagoscopy, flexible, transoral, with the removal of tumor(s), polyp(s), or other lesion(s) by snare technique. 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 43217?

CPT 43217 is used to describe a specific procedure called esophagoscopy, flexible, transoral, with the removal of tumor(s), polyp(s), or other lesion(s) by snare technique. This procedure involves the insertion of a flexible endoscope through the mouth to inspect the esophagus for any abnormalities. If any lesions, tumors, or polyps are found, they are removed using a snare technique, which utilizes a heated wire or loop to shave off the abnormal tissue.

2. Official Description

The official description of CPT code 43217 is: ‘Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique.’

3. Procedure

1. The procedure begins with the administration of anesthesia to the patient.
2. The healthcare provider inserts a flexible endoscope through the patient’s mouth and guides it down the throat and into the esophagus.
3. Using the endoscope, the provider carefully inspects the esophagus for any lesions, tumors, or polyps.
4. If any abnormalities are found, the provider uses a snare technique, which involves a heated wire or loop, to remove the lesion, tumor, or polyp.
5. The snare technique shaves off the abnormal tissue, effectively removing it from the esophagus.
6. The procedure is completed once all necessary removals have been performed.

4. Qualifying circumstances

CPT 43217 is used for patients who require the removal of tumor(s), polyp(s), or other lesion(s) from the esophagus using a snare technique. The procedure is typically performed on patients who have been diagnosed with esophageal abnormalities, such as tumors or polyps. It is important to note that CPT 43217 should not be reported in conjunction with CPT 43211 for the same lesion, and it should not be reported with CPT codes 43197, 43198, or 43200. For esophagogastroduodenoscopy with the removal of tumor(s), polyp(s), or other lesion(s) by snare technique, CPT code 43251 should be used. Additionally, for endoscopic mucosal resection, CPT code 43211 is the appropriate code to report.

5. When to use CPT code 43217

CPT code 43217 should be used when a healthcare provider performs esophagoscopy, flexible, transoral, and removes tumor(s), polyp(s), or other lesion(s) using a snare technique. This code is specific to the removal of abnormal tissue from the esophagus and should not be used for other procedures or body parts.

6. Documentation requirements

To support a claim for CPT 43217, the healthcare provider must document the following information:

• Patient’s diagnosis necessitating the procedure
• Specific details of the procedure performed, including the use of a snare technique
• Date of the procedure
• Any complications or additional findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43217, it is important to ensure that the procedure was performed as described in the official description. The healthcare provider should use the appropriate CPT code based on the specific procedure performed. It is also important to note that CPT 43217 should not be reported in conjunction with CPT 43211 for the same lesion. Additionally, it should not be reported with CPT codes 43197, 43198, or 43200. If the same procedure is performed, but the lesion or tumor is removed using hot biopsy forceps, CPT code 43216 should be reported instead.

8. Historical information

CPT 43217 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. It remains the specific code for esophagoscopy, flexible, transoral, with the removal of tumor(s), polyp(s), or other lesion(s) by snare technique.

9. Examples

1. A gastroenterologist performing esophagoscopy, flexible, transoral, with the removal of a tumor from a patient’s esophagus using a snare technique.
2. An otolaryngologist removing a polyp from a patient’s esophagus during an esophagoscopy, flexible, transoral, using a snare technique.
3. A general surgeon performing esophagoscopy, flexible, transoral, with the removal of multiple lesions from a patient’s esophagus using a snare technique.
4. A gastroenterologist removing a tumor from a patient’s esophagus during an esophagoscopy, flexible, transoral, using a snare technique.
5. An oncologist performing esophagoscopy, flexible, transoral, with the removal of a polyp from a patient’s esophagus using a snare technique.
6. A thoracic surgeon removing a lesion from a patient’s esophagus during an esophagoscopy, flexible, transoral, using a snare technique.