43450 is the correct code. The difference between the two codes are if a guide wire was placed and used to dilate the esophagus. Savary dilators is a BRAND name of a bougie and documentation supports that this was dilated without a guide wire.
Dilation of esophagus, by unguided sound or bougie, single or multiple passes
The physician dilates the esophagus using an unguided dilator. The physician passes a dilator into the patient's throat down into the esophagus until the end of the dilator passes the stricture. A stricture is a decrease in the esophagus opening as a result of cicatricial (scar) contraction or a deposit of abnormal tissue. The dilator is withdrawn after it passes the stricture. This may be repeated several times to dilate the esophagus to an acceptable size
Dilation of esophagus, over guide wire
The physician dilates the esophagus by passing dilators over a guidewire. The physician uses a fluoroscope to place a guidewire into the patient's throat, down the esophagus, and into the stomach. A series of olive-shaped metal dilators (Eder-Puestow) are passed over the guidewire and withdrawn. The process is repeated until the esophagus is dilated to an acceptable size.
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