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EGD with wire guided balloon dilation

coderguy1939

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I would appreciate any input regarding how this procedure should be coded. I can't find any code that includes wire guidance AND balloon dilation done endoscopically. Thanks.
 

debaloia

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I would use:

43245 Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie)
 

coderguy1939

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Thanks for your responses. This a dilation of the esophagus, so I don't think 43245 would work. I looked at the lay description of 43248 and it states that a dilator is passed over the guide wire to perform dilation and increasingly larger dilators can be used, but it does not state balloon dilation. Does anyone know definitively if 43248 includes balloon dilation?
 

Anna Weaver

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balloon

Thanks for your responses. This a dilation of the esophagus, so I don't think 43245 would work. I looked at the lay description of 43248 and it states that a dilator is passed over the guide wire to perform dilation and increasingly larger dilators can be used, but it does not state balloon dilation. Does anyone know definitively if 43248 includes balloon dilation?
I used 3M and went through this selecting EGD, dilation, balloon, over guidewire, and ended up with 43248. After checking the CPT then to confirm, I would use the 43248 as it indicates guidewire.
 

Shaheedahp

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I usually use 43248 if the scope was passed through the 2nd portion of the duodenum. If the scope didn't go pass the stomach I would use 43245...
 
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