CPT® Code 43256

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Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic stent placement (includes predilation)

The procedure described by CPT® Code 43256 involves an upper gastrointestinal endoscopy, which is a minimally invasive diagnostic and therapeutic procedure used to examine the upper digestive tract, including the esophagus, stomach, and either the duodenum and/or jejunum. This procedure is particularly indicated for treating stenosis, which refers to the narrowing of the upper digestive tract that can lead to difficulties in swallowing and other gastrointestinal symptoms. During the procedure, the patient is typically administered a local anesthetic spray to numb the mouth and throat, facilitating the insertion of a flexible fiberoptic endoscope. This endoscope is a thin, tube-like instrument equipped with a light and camera that allows for direct visualization of the upper gastrointestinal structures. As the patient swallows, the endoscope is carefully advanced through the mouth and throat, guided by the physician's direct visualization. The esophagus is thoroughly inspected for any abnormalities, followed by the stomach, which is insufflated with air to enhance visibility. The various regions of the stomach, including the cardia, fundus, greater and lesser curvature, and antrum, are examined for any pathological changes. The endoscope is then advanced through the pylorus into the duodenum and/or jejunum, where the mucosal surfaces are inspected. In cases where stenosis is identified, the procedure includes the dilation of the narrowed area to alleviate obstruction. Following this, a stent, which is a small tube designed to keep the passage open, is selected based on the size of the stenosis and is introduced through the endoscope. The stent is then positioned and deployed within the narrowed segment of the upper digestive tract. To ensure proper placement and expansion of the stent, separate radiographs are obtained, which are crucial for confirming that the stent is functioning as intended within the gastrointestinal tract.