Wiki esophagoscopy with dilation ,

[freespririt0806]

would coding this with a dilator be same as balloon dilation? Done by ENT

esophagoscopy withdrawn and 38 French dilator placed transoral to esophagus set for 5 minutes and withdrawn

43450 for the dilation
43200 for the diagnostic esophagoscopy
there does not appear to be CCI edit

Thank you

 

[thomas7331]

You haven't included enough of the operative report here to say for sure, but I think most likely the correct code here is 43214 for the dilation if it was done via flexible a endoscope. The diagnostic esophagoscopy would be inclusive to that code.

The dilation that is coded with 43450 is done via a guidewire, not with a scope - that's a different instrument from the one used in the esophagoscopy which is why there is no CCI edit there.

 

[freespririt0806]

You haven't included enough of the operative report here to say for sure, but I think most likely the correct code here is 43214 for the dilation if it was done via flexible a endoscope. The diagnostic esophagoscopy would be inclusive to that code.

The dilation that is coded with 43450 is done via a guidewire, not with a scope - that's a different instrument from the one used in the esophagoscopy which is why there is no CCI edit there.
thank you for this clarification on 43450


thank you for your reply , i have 2 and they were done by rigid scope
i was told i could not use complete op notes so i am trying to follow the rules, here is some more info
-- 28 tapered dilator place into esophagus wait 5 min for dilatory going up to 2 french, then i was able to put a 50 French dilator down, then jesberg scope reintroduce passed distal to the stenosis and withdrawn
i do appreciate your feed back

 

[thomas7331]

thank you for your reply , i have 2 and they were done by rigid scope
i was told i could not use complete op notes so i am trying to follow the rules, here is some more info
-- 28 tapered dilator place into esophagus wait 5 min for dilatory going up to 2 french, then i was able to put a 50 French dilator down, then jesberg scope reintroduce passed distal to the stenosis and withdrawn
i do appreciate your feed back

Dilation via a rigid scope is coded with 43195. The diagnostic esophagoscopy (43191) is inclusive and not coded separately.

A correction to my post above - dilation by flexible esophagoscopy would be 43220 because 38 French is less than 30 mm. 43214 would be for greater than 30 mm.