plugs; or cell washings may be performed by instilling a solution into the

esophagus
or stomach and then aspirating the solution out.

Optical endomicroscopy is the evaluation of tissue by imaging in situ and without

excision of
a specimen or the wait for pathology results. This technique is now used with
endoscopy to
examine the walls of the gastrointestinal system.

Esophagoscopy

An esophagoscopy allows the physician to visualize the esophagus. Esophagoscopic

photo�
dynamic therapy is coded as an ablation procedure, code 43229, in addition to code
96570 or
96571, as appropriate.

Esophagoscopies are coded based on the type of instrumentation used and the route
used
for the approach. Rigid esophagoscopy i coded to the 43191-43196 series. Transoral
flexible
esophagoscopy is coded to the 43200-43232 series and transnasal flexible
esophagoscopy is
coded to the 43197-43198 series.

Upper Gastrointestinal Endoscopies

Upper gastrointestinal endoscopies, often referred to as

esophagogastroduodenoscopies
(EGDs), are reported using codes 43235-43259. In these procedures, an endoscope is
inserted
through the mouth and down the throat to the esophagus, stomach, and either the
duodenum
and/or jejunum, as appropriate. Indications for these procedures include GI
bleeding, ulcer�
ation, or inflammation; abdominal pain; narrowing of the esophagus; and suspected
tumors or
polyps.

Figure 4.18 shows the passage of the endoscope during an upper GI endoscopy.