How To Use CPT Code 43227

CPT 43227 describes the procedure of esophagoscopy, flexible, transoral, with control of bleeding, using any method. 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 43227?

CPT 43227 is used to describe a specific procedure called esophagoscopy, flexible, transoral, with control of bleeding, using any method. This code is used when a healthcare provider inserts a flexible endoscope through the patient’s mouth to examine the esophagus and control bleeding if necessary.

2. Official Description

The official description of CPT code 43227 is: ‘Esophagoscopy, flexible, transoral; with control of bleeding, any method.’ It is important to note that this code should not be reported in conjunction with certain other codes for the same lesion or procedure.

3. Procedure

1. The healthcare provider administers anesthesia to the patient.
2. Using a flexible endoscope, the provider inserts the scope into the patient’s mouth and down the throat, reaching the esophagus.
3. The provider inspects the esophagus for any abnormalities or signs of bleeding.
4. If bleeding is present, the provider uses various methods to control it, such as injecting chemicals directly into the bleeding site, electrocautery, heat probe, laser, tying off or banding the bleeding vessel, tamponade, or Argon plasma coagulation (APC).
5. With APC, a high-frequency current is passed through a probe to coagulate the blood in the affected area or tissue.

4. Qualifying circumstances

CPT 43227 is used for patients who require esophagoscopy with control of bleeding. This procedure is typically performed when there is a need to inspect the esophagus for abnormalities or signs of bleeding. The healthcare provider must use a flexible endoscope and be able to control bleeding using various methods.

5. When to use CPT code 43227

CPT code 43227 should be used when a healthcare provider performs an esophagoscopy with the specific purpose of controlling bleeding. It is important to note that this code should not be reported in conjunction with certain other codes for the same lesion or procedure.

6. Documentation requirements

To support a claim for CPT 43227, the healthcare provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Details of the procedure, including the use of a flexible endoscope and the specific methods used to control bleeding
• Date and duration of the procedure
• Any complications or additional interventions performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43227, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code should not be reported in conjunction with certain other codes for the same lesion or procedure. Pay attention to any additional guidelines or restrictions provided by the payer or coding guidelines.

8. Historical information

CPT 43227 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including updates in 2002 and 2014 to clarify the description and specify the methods of controlling bleeding.

9. Examples

1. A gastroenterologist performing an esophagoscopy with control of bleeding using electrocautery for a patient with esophageal varices.
2. An otolaryngologist using a flexible endoscope to inspect the esophagus and control bleeding with injection therapy for a patient with esophageal ulcers.
3. A general surgeon performing an esophagoscopy with control of bleeding using laser therapy for a patient with esophageal cancer.
4. An interventional radiologist using a flexible endoscope to inspect the esophagus and control bleeding with APC for a patient with Mallory-Weiss syndrome.
5. A thoracic surgeon performing an esophagoscopy with control of bleeding using band ligation for a patient with esophageal varices.
6. A gastroenterologist using a flexible endoscope to inspect the esophagus and control bleeding with heat probe for a patient with angiodysplasia.
7. An otolaryngologist performing an esophagoscopy with control of bleeding using tamponade for a patient with a bleeding esophageal ulcer.
8. A general surgeon using a flexible endoscope to inspect the esophagus and control bleeding with injection therapy for a patient with Dieulafoy’s lesion.
9. An interventional radiologist performing an esophagoscopy with control of bleeding using APC for a patient with radiation-induced esophagitis.
10. A thoracic surgeon using a flexible endoscope to inspect the esophagus and control bleeding with laser therapy for a patient with esophageal leiomyoma.