Gastroenterology Coding Alert

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.