AHA Coding Clinic® for HCPCS - 2026 Issue 1; Ask the Editor

Transnasal Esophagoscopy with Dilation

A patient with dysphagia due to cervical esophageal stenosis undergoes transnasal flexible esophagoscopy. The flexible esophagoscope is advanced through the nasal cavity into the esophagus, and the stenotic segment is visualized. A complete diagnostic esophagoscopy was performed.A guidewire is passed through the stenosis under endoscopic visualization. The esophagoscope is then withdrawn, and a “sidecar” technique is used to visualize the stenosis. Balloon dilators are passed over the guidewire and positioned at the cervical esophageal stenosis. Serial balloon dilation was performed, inflating to a maximum diameter of 29 mm and held for one minute. The instruments were withdrawn, and the procedure was tolerated without complications.Since the approach is transnasal rather than transoral, should standard esophagoscopy with dilation CPT codes be reported, or should an alternate dilation or unlisted code be assigned? ...

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