CPT® Code 43204

Esophagoscopy, flexible, transoral, is a medical procedure that involves the use of a flexible endoscope to visualize and treat conditions affecting the esophagus. This procedure is specifically indicated for the treatment of esophageal varices, which are abnormally dilated blood vessels located within the esophageal wall. These varices are often a consequence of portal hypertension, a condition frequently associated with liver cirrhosis. During the esophagoscopy, the endoscope is carefully introduced through the patient's mouth and advanced into the esophagus, allowing for a thorough examination of the upper digestive tract. The procedure includes the assessment of various anatomical structures, such as the velopharyngeal closure, the base of the tongue, and the hypopharynx, as well as the evaluation of vocal cord motion and pharyngeal musculature. The endoscope is maneuvered past the cricopharyngeus muscle, often requiring the patient to perform actions like burping or swallowing to facilitate its passage. Once the endoscope reaches the gastroesophageal junction, any abnormalities can be documented. Following the examination, the esophagus is scrutinized in its entirety as the scope is withdrawn. In the context of CPT® Code 43204, the procedure involves the injection of a sclerosing solution directly into the esophageal varices, which serves to shrink these dilated vessels, thereby reducing the risk of bleeding. This contrasts with the alternative procedure described by CPT® Code 43205, where a band ligation technique is employed to tie off the varices using an elastic band.