Wiki EGD Foreign Body removal 43247


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Two questions;
1. If EGD report states food bolus was pushed into the stomach can this be billed as 43247? The CPT description uses the words, removed, withdrawn, so this has me thinking the bolus must actually be removed from the body completely via the mouth.

The flexible fiberoptic endoscope is then inserted and advanced as it is swallowed by the patient. Once the endoscope has been advanced beyond the cricopharyngeal region, it is guided using direct visualization. The endoscope is advanced to the site of the foreign body. A balloon catheter may be used to remove a smooth edged foreign body, such as a coin. The catheter tip is passed beyond the level of the foreign body and the balloon is inflated. The catheter is then withdrawn and the foreign body is carefully pulled out of the esophagus. An impacted foreign body such as a piece of meat is removed with forceps. The forceps are passed through the endoscope and the impacted foreign body is grasped and removed. A sharp foreign body such as a tack or razor blade is first maneuvered into the lumen of the scope using forceps and the foreign body and scope are removed. Following removal of the foreign body(s), the endoscope is reintroduced and the esophagus, stomach, duodenum, and/or jejunum are examined for evidence of perforation or other injury.

2. Does the method of removal of the food bolus/foreign body have to be documented to bill 43247? (balloon catheter, forceps, forceps with hood etc.) If method of removal has to be documented, where can I find this published requirement?
"Food was found in the lower third of esophagus. Removal of food was accomplished".

Thank you
We've always billed 43247 when the provider 'removed' the food bolus by pushing it down into the stomach. It's removed from the esophagus, right? Here is a link to an article in CMS that might be helpful in regards to your 2nd question. I don't know if it covers your area.