© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 39200 involves the surgical resection of a mediastinal cyst, which is a fluid-filled sac located in the mediastinum, the central compartment of the thoracic cavity. This area is situated between the lungs and contains vital structures such as the heart, trachea, esophagus, and major blood vessels. The term "resection" refers to the surgical removal of the cyst, which may be necessary due to symptoms caused by the cyst or concerns regarding its nature. The approach taken by the physician during this procedure is determined by the specific location of the cyst within the mediastinum. For cysts located in the anterior mediastinum, a median sternotomy is typically performed, which involves making an incision along the sternum to gain access to the chest cavity. Conversely, for cysts situated in the posterior mediastinum, a posterolateral approach is utilized, allowing access from the side of the chest. During the procedure, the surgeon carefully dissects through the surrounding tissues to reach the mediastinal space, where the cyst or tumor is identified and exposed. If the lesion is confirmed to be cystic, the goal is to remove it completely, including the cyst wall, to minimize the risk of recurrence. However, if the cyst wall is found to be adherent to critical structures such as the tracheobronchial tree or esophagus, complete resection may not be feasible, and the surgeon will instead remove the mucosal lining of the affected area. In cases where a mediastinal tumor is present, the objective is to excise the tumor entirely whenever possible. After the successful removal of the cyst or tumor, the surgical incisions are meticulously closed in layers to promote proper healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of resection of a mediastinal cyst is indicated for various clinical scenarios where the presence of a cyst may lead to complications or symptoms. The following conditions may warrant this surgical intervention:
The surgical procedure for the resection of a mediastinal cyst involves several critical steps, each aimed at ensuring the safe and effective removal of the cyst. The following outlines the procedural steps:
Following the resection of a mediastinal cyst, patients are typically monitored in a recovery area for any immediate postoperative complications. Pain management is provided as needed, and patients may be advised on respiratory exercises to promote lung expansion and prevent complications such as atelectasis. The expected recovery period may vary based on the extent of the surgery and the patient's overall health. Follow-up appointments are scheduled to monitor healing and assess for any signs of recurrence or complications. Patients are instructed to report any unusual symptoms, such as increased pain, fever, or respiratory difficulties, to their healthcare provider promptly.
| Short Descr | RESECT MEDIASTINAL CYST | Medium Descr | RESECTION OF MEDIASTINAL CYST | Long Descr | Resection of mediastinal cyst | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
This is a primary code that can be used with these additional add-on codes.
| 32674 | Add-on Code MPFS Status: Active Code APC C Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) | 38746 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2012-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Medium description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.