Gastroenterology Coding Alert

Question: The provider views the esophagus by means of rigid endoscope through the mouth. He also collects specimens by brushing. What is the most appropriate code for this?

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Answer: In this case, the provider has performed transoral esophagoscopy using a rigid endoscope, and has also collected specimen by brushing. You may therefore report 43191, (Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen[s] by brushing or washing when performed [separate procedure]).

If the provider had used the transnasal route and a flexible scope, you would report 43197 (Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]).  

In case the provider used a flexible peroral instrument, you would report 43200 (Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]).

Also, do not report 43191along other esophagoscopy codes such as:

• 43192 (Esophagoscopy, rigid, transoral; with directed submucosal injection[s], any substance )
• 43193 (…with biopsy, single or multiple)
• 43194 (… with removal of foreign body[s])
• 43195 (…with balloon dilation [less than 30 mm diameter])
• 43196 (… with insertion of guide wire followed by dilation over guide wire )
• 43198 (Esophagoscopy, flexible, transnasal; with biopsy, single or multiple)
• 43210 (Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed)