CPT® Code 43257

Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease

The procedure described by CPT® Code 43257 involves a specialized endoscopic technique known as esophagogastroduodenoscopy (EGD), which is performed using a flexible, transoral approach. This procedure is primarily indicated for the treatment of gastroesophageal reflux disease (GERD), a condition where stomach acid frequently flows back into the esophagus, causing symptoms such as heartburn and regurgitation. During the procedure, the patient’s mouth and throat are first numbed with an anesthetic spray to minimize discomfort. A hollow mouthpiece is then placed in the mouth to facilitate the insertion of the flexible fiberoptic endoscope. 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 reaches the stomach, it is inflated with air to enhance visibility, and various regions of the stomach, including the cardia, fundus, greater and lesser curvature, and antrum, are thoroughly inspected. The procedure may extend into the duodenum or jejunum, where the mucosal surfaces are also examined. A guidewire is then introduced through the endoscope to assist in the placement of a thermal catheter, which is used to deliver thermal energy to the lower esophageal sphincter and/or gastric cardia. This thermal energy is intended to create lesions that can help alleviate the symptoms of GERD by modifying the function of the esophageal sphincter. The careful monitoring and inspection throughout the procedure ensure that the thermal lesions are accurately placed, contributing to the overall effectiveness of the treatment.