CPT® Code 74235

The procedure described by CPT® Code 74235 involves the removal of foreign body(ies) from the esophagus utilizing a balloon catheter, with the added component of radiological supervision and interpretation. This method serves as a non-sedated alternative to traditional endoscopy for extracting non-organic, smooth, and radiopaque objects lodged in the esophagus. The use of fluoroscopy is critical in this procedure, as it allows for the precise confirmation of the foreign body(ies) location, shape, and size prior to intervention. The procedure is designed to be performed with the patient in an upright position, ensuring optimal access and visibility during the removal process. The balloon catheter, specifically a Foley catheter, is selected based on the size of the foreign body and is tested for symmetrical inflation to ensure effective operation. The catheter is then inserted either trans-orally or trans-nasally, and the patient is instructed to swallow it. Under continuous fluoroscopic guidance, the catheter is advanced until it is positioned distal to the foreign body(ies). Once in place, the balloon is inflated to expand the esophageal lumen, facilitating the movement of the foreign object. The patient is then repositioned to a prone or oblique position, and gentle traction is applied to the catheter, utilizing gravity to assist in the expulsion of the foreign body(ies) from the esophagus. Following the successful removal, the balloon is deflated, and the catheter is carefully withdrawn. This code not only encompasses the procedural aspects but also includes the radiological supervision, the review and interpretation of the imaging obtained during the procedure, and the documentation of findings in a written report.