CPT® Code 43214

Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)

Esophagoscopy, specifically the flexible transoral approach, is a medical procedure that involves the use of a flexible endoscope to visualize and treat conditions affecting the esophagus. This procedure is particularly focused on the dilation of the esophagus using a balloon that is 30 mm in diameter or larger. The primary purpose of esophageal dilation is to alleviate strictures, which are areas of narrowing within the esophagus that can impede the passage of food and liquids. Such strictures may arise from various underlying conditions, including reflux esophagitis, which leads to inflammation and scarring of the esophageal lining; Schatzki's ring, a benign fibrous tissue formation located in the distal esophagus; congenital esophageal atresia, a birth defect affecting the esophagus; or malignant diseases that can cause obstruction. During the procedure, the endoscope is introduced through the mouth, allowing for a thorough examination of the velopharyngeal closure, base of the tongue, and hypopharynx. The motion of the vocal cords is assessed, and the pharyngeal musculature is evaluated. As the endoscope is advanced to the cricopharyngeus, the patient may be instructed to burp or swallow to facilitate the passage of the scope. The entire length of the esophagus is then examined, and any abnormalities are documented. Following this, the balloon catheter is carefully advanced to the site of the stricture, where it is inflated to the appropriate pressure to achieve dilation. The balloon remains inflated for a brief period, after which it is deflated and removed. The area of stricture is subsequently inspected to confirm the success of the dilation and to check for any potential injuries resulting from the procedure.