CPT® Code 43255

Esophagogastroduodenoscopy (EGD) is a diagnostic and therapeutic procedure that involves the use of a flexible endoscope to visualize the upper gastrointestinal (GI) tract, which includes the esophagus, stomach, and duodenum. This procedure is performed transorally, meaning that the endoscope is inserted through the mouth. The primary purpose of this specific EGD, coded as CPT® 43255, is to control bleeding within the upper GI tract using various methods. Prior to the procedure, local anesthetic spray is applied to numb the mouth and throat, facilitating the insertion of the endoscope. A hollow mouthpiece is utilized to keep the mouth open during the procedure. Once the endoscope is inserted, it is advanced as the patient swallows, allowing for smooth passage through the esophagus. The endoscope is guided with direct visualization, enabling the physician to inspect the esophagus for any abnormalities. After thorough examination of the esophagus, the endoscope is further advanced into the stomach, where air is insufflated to enhance visibility. The cardia, fundus, greater and lesser curvature, and antrum of the stomach are meticulously inspected for any signs of pathology. The procedure continues as the endoscope is passed through the pylorus into the duodenum and/or jejunum, where the mucosal surfaces are also examined for abnormalities. In cases where bleeding is identified, various techniques are employed to control it. These may include the application of thermal modalities such as bipolar or unipolar cautery, or the use of a heater probe to directly address the bleeding site. Additionally, an injection of epinephrine may be administered to constrict blood vessels and aid in controlling the hemorrhage. Noncontact methods such as YAG laser coagulation and argon plasma coagulation are also available for coagulating the bleeding site. In instances of tears or lacerations, staples or hemoclips may be utilized to approximate the margins and facilitate healing. This comprehensive approach ensures effective management of bleeding within the upper GI tract during the esophagogastroduodenoscopy procedure.