AHA Coding Clinic® for HCPCS - 2026 Quarter 3; Ask the Editor

Endoscopic Esophageal Stent Securement

A patient underwent esophagogastroduodenoscopy for evaluation of dysphagia and was found to have a benign-appearing intrinsic severe esophageal stenosis located 30-35 cm from the incisors, measuring approximately 7 mm in diameter and 5 cm in length. The stenosis was successfully traversed after downsizing the endoscope. A fully covered 20 mm x 100 mm esophageal stent was placed under fluoroscopic guidance, with appropriate proximal and distal positioning confirmed. Following stent deployment, the endoscope was withdrawn and reintroduced with an endoscopic suturing device. Two interrupted 2-0 polypropylene sutures with cinches were placed to secure the stent and reduce the risk of migration. Good tissue approximation was achieved, and there were no complications such as bleeding. When an esophageal stent is inserted endoscopically, is it appropriate to report a separate code for securing the stent (e.g., endoscopic suturing or fixation), or is this work considered integral to the primary stent placement procedure? ...

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