CPT 2014 Overview of GI Changes The following table is a listing of the new,, and deleted codes in the Esophagus/Endoscopy section effective January 1, 2014. The table lists the CPT code, a brief description of the included services for each code and other notable changes. Detailed information regarding these codes such as full descriptors, guidelines, parenthetical notes, rationales and clinical examples can be found in CPT Changes 2014: An Insider s View. This important resource provides a complete review of all 2014 CPT code additions, deletions and revisions that impact various clinical areas including the Cardiovascular System, Molecular Pathology, Complex Chronic Care Coordination Services, Transitional Care Management Services and Appendix C. You may learn more by visiting amastore.com. Key to symbols used: Code Code Add On Code Moderate Sedation # Out of Numerical Sequence Code Change Type CPT Code Procedure(s) Change Detail 43191 rigid transoral diagnostic brushing washing 43192 rigid transoral submucosal injection(s) 43193 rigid transoral biopsy 43194 rigid transoral 43200 For transnasal, use 43197 43201 43202 For transnasal, use 43198 43215 foreign body 43195 rigid transoral balloon dilation 43220 1
43196 rigid transoral 43226 guide wire insertion 43197 flexible transnasal diagnostic brushing washing 43198 flexible transnasal biopsy For rigid transoral, use 43191 For flexible transoral, use 43200 For rigid transoral, use 43193 For flexible transoral, use 43202 43200 diagnostic brushing washing 43201 submucosal injection(s) 43202 biopsy 43204 varices injections 43205 band ligation 43191 For transnasal, use 43197 43192 43193 For transnasal, use 43198 43499 2
43206 optical endomicroscopy 43215 foreign body 43194 43216 hot biopsy or cautery 43217 snare lesion # 43211 mucosal resection concept # 43212 stent placement concept Deleted 43219 Use 43212 43220 balloon dilation 43195 # 43213 retrograde dilation concept # 43214 balloon dilation including imaging concept 3
43226 guide wire insertion 43196 43227 control of bleeding Terminology reconciliation with 43255 Deleted 43228 Use 43229 43229 ablation Includes balloon dilation, insertion of guide wire, and ablation 43220, 43226, 43228 43231 43232 ultrasound-guided needle aspiration 43235 diagnostic brushing washing Terminology reconciliation 43236 injection(s) Includes injection of varices, endoscopic mucosal resection, and control of bleeding described by 43243, 43254, 43255 for same lesion 4
43237 43238 ultrasound-guided needle aspiration 43239 biopsy 43240 pseudocyst drainage catheter(s)/stent(s) placement Includes placement of drain, stent, transmural needle aspiration and ultrasound described by 43242, 43259, 43236 43241 tube or catheter insertion 43242 ultrasound-guided needle aspiration 43243 sclerosis of varices Includes submucosal injections and control of bleeding reported 43236, 43255 43244 band ligation Includes endoscopic mucosal resection and control of bleeding described by 43254, 43255 for same lesion 5
43245 stricture dilation Includes tumor ablation, stent placement, guide wire passage and dilation 43266, 43270 43246 gastrostomy tube placement 43247 foreign body 43248 guide wire insertion Includes stent placement, guide wire passage and dilation 43266 43249 balloon dilation Includes tumor ablation, stent placement described by codes 43266, 43270 # 43233 balloon dilation Dilation includes imaging 43250 hot biopsy or bipolar cautery 43251 snare technique Includes endomucosal resection 43254 for same lesion 6
43252 optical endomicroscopy # 43253 ultrasound-guided injection Not separately reportable with ultrasound 43237, 43238, 43242, 43259, 76942, 76975 or with pseudocyst drainage 43240 # 43254 mucosal resection Includes injection (43236), banding (43243/43244), and snare polyp (43251) for the same lesion 43255 control of bleeding Includes injection and ligation, of varices 43243, 43244 for the same lesion Deleted 43256 Use 43266 # 43266 stent placement Includes pseudocyst drainage described by 43240, tube placement described by 43241 or dilations 43245, 43248, 43249 for same lesion 43257 thermal GERD treatment Deleted 43258 Use 43270 7
# 43270 ablation Includes guide wire insertion and esophageal dilation codes 43248, 43249 for same lesion 43259 Includes pseudocyst drainage 43240 43260 diagnostic brushing and washing Terminology reconciliation No Change 43262 Bundles stent placement 43274, stent exchange 43276 and dilation 43277 43263 43264 pressure measurement calculi/debri 43265 calculi destruction Includes stone destruction 43265 Includes of calculi/debris from duct(s) 43264 Deleted 43267 Use 43274 Deleted 43268 Use 43274 8
# 43274 stent placement sphincterotomy Includes sphincterotomy 43262 destruction of debris 43275, 43276, 43277 in same duct Deleted 43269 See 43275, 43276 Deleted 43271 Use 43277 Deleted 43272 Use 43278 # 43275 foreign body/stent Includes stent and exchange 43276 # 43276 and exchange of stent sphincterotomy Includes stent, 43275 # 43277 sphincteroplasty sphincterotomy Includes stent placement 43274, stent exchange 43276 and ablation described by 43278 # 43278 ablation Includes guide wire passage, and dilation 43273 endoscopic papilla cannulation visualization of pancreatic/common bile duct(s) Terminology reconciliation 9
43450 esophagus dilation Moderate sedation now included Deleted 43456 Use 43213 Deleted 43458 See 43214, 43233 10