CPT® Code 43248

Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire

The procedure described by CPT® Code 43248 involves a flexible esophagogastroduodenoscopy (EGD) performed transorally, which means the endoscope is inserted through the mouth. This procedure is specifically designed to allow for the examination of the upper gastrointestinal (UGI) tract, including the esophagus, stomach, and duodenum. A key component of this procedure is the insertion of a guide wire, which facilitates the subsequent passage of dilators through the esophagus. The primary purpose of this intervention is to treat strictures in the esophagus, which can occur due to various conditions such as reflux esophagitis, Schatzki's ring, congenital esophageal atresia, or malignant diseases. During the procedure, the patient’s mouth and throat are numbed with an anesthetic spray to minimize discomfort. A hollow mouthpiece is then placed in the mouth to keep it open. The flexible fiberoptic endoscope is carefully inserted and advanced as the patient swallows, allowing for direct visualization of the esophagus. Once the endoscope passes the cricopharyngeal region, it is guided into the esophagus to the site of the stricture. The insertion of the guide wire through the endoscope is a critical step, as it enables the operator to pass a series of dilators over the wire to effectively dilate the stricture. This procedure is essential for restoring normal esophageal function and alleviating symptoms associated with esophageal strictures.