CPT® Code 43236

An esophagogastroduodenoscopy (EGD), also known as an upper gastrointestinal (UGI) endoscopic examination, is a procedure that allows for the visualization of the esophagus, stomach, duodenum, and/or jejunum. This flexible, transoral procedure involves the use of a fiberoptic endoscope, which is a thin, flexible tube equipped with a light and camera. The procedure begins with the administration of a local anesthetic spray to numb the mouth and throat, facilitating the insertion of the endoscope. A hollow mouthpiece is placed in the patient's mouth to keep it open during the examination. As the patient swallows, the endoscope is carefully advanced through the esophagus, allowing for direct visualization of the esophageal lining and any potential abnormalities. Once the endoscope passes the gastroesophageal junction, it is further advanced into the stomach, where air is insufflated to expand the stomach for better visibility. The various regions of the stomach, including the cardia, fundus, greater and lesser curvature, and antrum, are thoroughly inspected for any irregularities. The procedure continues as the endoscope is advanced through the pylorus into the duodenum and/or jejunum, where the mucosal surfaces are examined for abnormalities. In addition to visual inspection, the procedure may involve directed submucosal injections of various substances. These injections can serve multiple purposes, such as enhancing visualization of lesions, creating a fluid cushion to facilitate lesion removal, or treating specific conditions like esophageal achalasia. Common substances used for these injections include India ink, botulinum toxin, saline, epinephrine, and corticosteroid solutions. Following the injections, the endoscope is withdrawn, and the mucosal surfaces are re-evaluated for any signs of ulcerations, varices, bleeding, lesions, strictures, or other abnormalities. In cases where a diagnostic EGD is performed, cytology samples may also be collected through brushing or washing techniques.