READER QUESTIONS:
Lack of Guide Wire Changes Dilator Code
Published on Sat Feb 05, 2005
Question: If our gastroenterologist places a dilator during an endoscopy without using a guide wire, how should I code the scenario?
Mississippi Subscriber
Answer: Many dilator placements require the use of a guide wire and/or an endoscope, but there are certain dilators that a gastroenterologist can insert into a patient without using a guide wire at all.
Use 43450 (Dilation of esophagus, by unguided sound or bougie, single or multiple passes) when the gastro inserts and manipulates the dilator non-endoscopically. If the gastro performs an endoscopy predilation, that should be reported separately.
Hot tip: According to the 1994 CPT Assistant, gastroenterologists use Hurst- and Maloney-type dilators during 43450 procedures. If you're unsure whether to report 43450, you may want to check and see if the gastro used one of these dilators.
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