CPT® Code 43450

The procedure described by CPT® Code 43450 involves the dilation of the esophagus using unguided sound or bougie, which can be performed in single or multiple passes. This technique is utilized when a physician aims to alleviate esophageal strictures, which are narrowings of the esophagus that can occur due to various conditions such as esophageal reflux, benign or malignant lesions, or other forms of injury or disease. Unlike other methods that may involve direct visualization, this procedure is conducted without the use of endoscopic guidance, meaning the physician does not visually monitor the dilation process. Instead, a series of progressively larger rigid rubber tubes, known as sounds or bougies, are inserted through the mouth and advanced into the esophagus to gradually widen the narrowed area. It is important to note that a separate esophagram may be performed prior to this procedure to accurately identify the location and extent of the stricture, and fluoroscopy may also be utilized during the dilation to assist in the process. This code specifically refers to the method where no guide is employed for the passage of the sounds or bougies, distinguishing it from related procedures that may use a guidewire for assistance.