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Official Description

Esophagoscopy, flexible, transoral; with removal of foreign body(s)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Esophagoscopy, flexible, transoral, is a medical procedure that involves the use of a flexible endoscope to examine the esophagus and remove foreign bodies that may be lodged within it. This procedure is performed by introducing the endoscope through the mouth and advancing it into the esophagus, allowing for direct visualization of the esophageal lumen. The flexible nature of the endoscope enables the physician to navigate the curves of the esophagus effectively. During the procedure, various techniques may be employed to remove foreign bodies, depending on their size, shape, and location. For instance, a balloon catheter can be utilized to extract smooth-edged foreign bodies, such as coins, by inflating the balloon beyond the foreign object and then withdrawing it to pull the object out. In cases where the foreign body is impacted, such as a piece of meat, forceps are used to grasp and remove the object. The procedure may also involve nudging impacted food into the stomach if removal is not feasible. Additionally, sharp foreign bodies, like tacks or razor blades, can be maneuvered into the lumen of the endoscope for safe extraction. After the foreign body is removed, the endoscope is reintroduced to re-examine the esophagus for any signs of perforation or injury, ensuring that the esophagus is intact and free from complications following the removal process.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of esophagoscopy, flexible, transoral, is indicated for the following conditions:

  • Foreign Body Ingestion The procedure is performed when a patient has ingested a foreign body that has become lodged in the esophagus, causing potential obstruction or injury.
  • Impacted Food It is indicated for cases where food has become impacted in the esophagus, leading to difficulty swallowing or potential esophageal obstruction.
  • Sharp Foreign Bodies The procedure is necessary for the removal of sharp foreign bodies, such as tacks or razor blades, which pose a risk of perforation or injury to the esophageal lining.

2. Procedure

The procedure of esophagoscopy, flexible, transoral, involves several key steps to ensure the safe and effective removal of foreign bodies from the esophagus:

  • Step 1: Preparation The patient is positioned appropriately, and sedation may be administered to ensure comfort during the procedure. The physician prepares the flexible endoscope and any necessary tools, such as forceps or balloon catheters, for the removal process.
  • Step 2: Introduction of the Endoscope The flexible endoscope is carefully introduced through the patient's mouth and advanced into the esophagus. The physician visualizes the esophagus on a monitor, allowing for precise navigation to the location of the foreign body.
  • Step 3: Removal of Smooth-Edged Foreign Bodies If a smooth-edged foreign body, such as a coin, is identified, a balloon catheter may be utilized. The catheter tip is passed beyond the level of the foreign body, and the balloon is inflated. The catheter is then withdrawn, pulling the foreign body out of the esophagus.
  • Step 4: Removal of Impacted Foreign Bodies In cases where the foreign body is impacted, such as a piece of meat, forceps are passed through the endoscope. The physician grasps the impacted foreign body with the forceps and carefully removes it from the esophagus. If removal is not possible, the impacted food may be nudged into the stomach using the forceps.
  • Step 5: Removal of Sharp Foreign Bodies For sharp foreign bodies, the endoscope is maneuvered to visualize the object. The physician uses forceps to grasp the sharp foreign body and carefully extracts it, ensuring that it is removed safely without causing injury to the esophagus.
  • Step 6: Re-examination of the Esophagus After the foreign body has been removed, the endoscope is reintroduced to re-examine the esophagus for any signs of perforation or other injuries that may have occurred during the procedure.

3. Post-Procedure

Following the esophagoscopy procedure, patients are typically monitored for any immediate complications. They may be advised to refrain from eating or drinking until the effects of sedation have worn off and the physician has confirmed that the esophagus is free from injury. Patients may experience some throat discomfort or soreness, which is generally temporary. Follow-up care may include instructions on diet and activity restrictions, as well as signs and symptoms to watch for that may indicate complications, such as difficulty swallowing, chest pain, or persistent vomiting. The physician will provide guidance on when the patient can resume normal activities and diet based on their individual recovery progress.

Short Descr ESOPHAGOSCOPY FLEX REMOVE FB
Medium Descr ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
Long Descr Esophagoscopy, flexible, transoral; with removal of foreign body(s)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 43200  Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8B - Endoscopy - upper gastrointestinal
MUE 1
CCS Clinical Classification 229 - Nonoperative removal of foreign body
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2015-01-01 Changed Description Changed
2014-01-01 Changed Description Changed
Pre-1990 Added Code added.
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