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Thoracoscopy, surgical; with esophagomyotomy (Heller type) is a minimally invasive surgical procedure that involves the use of a thoracoscope, which is a specialized instrument equipped with a camera and light source. This procedure is specifically designed to treat conditions affecting the esophagus, particularly those related to esophageal motility disorders. The term "esophagomyotomy" refers to the surgical incision made in the muscular layer of the esophagus to alleviate symptoms associated with conditions such as achalasia, where the esophagus has difficulty moving food into the stomach. The procedure is performed through small incisions in the chest wall, allowing for a direct view of the esophagus while minimizing trauma to surrounding tissues. The use of video-assisted thoracoscopic surgery (VATS) enhances the surgeon's ability to visualize the surgical field, leading to improved precision and potentially quicker recovery times for patients. The approach typically involves creating an artificial pneumothorax to facilitate access to the esophagus, followed by careful dissection and incision of the esophageal muscle, which is crucial for relieving the obstruction and restoring normal function.
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Esophagomyotomy (Heller type) is indicated for patients suffering from specific esophageal motility disorders. The primary conditions for which this procedure is performed include:
The procedure for thoracoscopy with esophagomyotomy involves several critical steps to ensure successful surgical intervention. The following outlines the procedural steps:
After the thoracoscopy with esophagomyotomy, patients typically require monitoring for any complications related to the procedure. Expected recovery includes management of pain, monitoring for signs of infection, and ensuring proper function of the esophagus. The placement of a nasogastric tube aids in the initial postoperative feeding protocol, allowing for gradual reintroduction of oral intake as tolerated. Patients may also be advised on activity restrictions and follow-up appointments to assess healing and the effectiveness of the procedure.
| Short Descr | THORACOSCOP W/ESOPH MUSC EXC | Medium Descr | THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE | Long Descr | Thoracoscopy, surgical; with esophagomyotomy (Heller type) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
| 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2011-01-01 | Changed | Short description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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