How To Use CPT Code 43229

CPT 43229 describes a specific procedure involving the use of a flexible endoscope to perform ablation of one or more lesions in the esophagus. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43229?

CPT 43229 is a code used to describe a procedure in which a qualified healthcare provider inserts a flexible endoscope through the patient’s mouth and into the esophagus. The purpose of this procedure is to perform ablation of one or more lesions, polyps, or tumors in the esophagus. The provider may also use guidewires and dilators to widen the esophagus before and after the ablation process.

2. Official Description

The official description of CPT code 43229 is: ‘Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed).’ It is important to note that this code should not be reported in conjunction with other specific codes for the same lesion or other related procedures.

3. Procedure

1. The healthcare provider administers anesthesia to the patient.
2. Using a flexible endoscope, the provider inserts the scope through the patient’s mouth and down the throat into the esophagus.
3. The provider carefully inspects the esophagus for any lesions, polyps, or tumors that require ablation.
4. Using specialized tools and techniques, the provider performs the ablation process to destroy the identified lesions.
5. If necessary, the provider may dilate the esophagus before or after the ablation procedure to facilitate the treatment.
6. Guidewires may be used to guide the endoscope and dilators during the procedure.

4. Qualifying circumstances

CPT 43229 is typically performed on patients who have been diagnosed with esophageal lesions, polyps, or tumors that require ablation. The procedure is carried out by a qualified healthcare provider who has the necessary expertise and training in performing esophagoscopy. It is important to note that this code should not be reported in conjunction with other specific codes for the same lesion or other related procedures.

5. When to use CPT code 43229

CPT code 43229 should be used when a qualified healthcare provider performs a flexible esophagoscopy with ablation of one or more lesions, polyps, or tumors in the esophagus. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code. This code should not be reported in conjunction with other specific codes for the same lesion or other related procedures.

6. Documentation requirements

To support a claim for CPT code 43229, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for ablation of esophageal lesions, polyps, or tumors
• Details of the procedure, including the use of a flexible endoscope, ablation techniques, and any additional procedures performed (such as dilation or guidewire passage)
• Date and duration of the procedure
• Any complications or adverse events that occurred during or after the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 43229, it is important to ensure that the procedure meets the specific criteria outlined in the official description. This code should not be reported in conjunction with other specific codes for the same lesion or other related procedures. It is important to review the documentation requirements and ensure that all necessary information is included in the claim. Additionally, it is important to follow any specific billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 43229 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 performing a flexible esophagoscopy with ablation of a tumor in the esophagus.
2. An oncologist using a flexible endoscope to perform ablation of multiple polyps in the esophagus.
3. A surgeon performing a flexible esophagoscopy with ablation of a lesion in the esophagus.
4. A gastroenterologist using a flexible endoscope to perform ablation of a tumor in the esophagus, followed by dilation of the esophagus.
5. An interventional radiologist performing a flexible esophagoscopy with ablation of a lesion in the esophagus, using guidewires to facilitate the procedure.
6. A gastroenterologist performing a flexible endoscopy with ablation of a tumor in the esophagus, followed by post-dilation of the esophagus.
7. A surgeon using a flexible endoscope to perform ablation of multiple polyps in the esophagus, followed by dilation of the esophagus.
8. An oncologist performing a flexible esophagoscopy with ablation of a lesion in the esophagus, using guidewires to facilitate the procedure.
9. A gastroenterologist using a flexible endoscope to perform ablation of a tumor in the esophagus, followed by post-dilation of the esophagus.
10. An interventional radiologist performing a flexible esophagoscopy with ablation of a lesion in the esophagus, using guidewires to facilitate the procedure and post-dilation of the esophagus.