© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 42953 refers to a surgical procedure known as pharyngoesophageal repair, which involves the plastic or reconstructive repair of the pharynx and the cervical esophagus. This procedure is essential for addressing defects or malformations in these areas, which can arise from various conditions such as trauma, congenital anomalies, or disease processes. The term 'pharyngoesophageal repair' indicates that both the pharynx, the part of the throat behind the mouth, and the esophagus, the tube that carries food from the throat to the stomach, are involved in the surgical intervention. The procedure typically begins with an incision in the neck, allowing access to the pharynx and esophagus. The surgical approach may vary based on the specific type of defect present, and the surgeon must carefully evaluate the extent of the injury to determine the most appropriate method of repair. This may involve direct closure of the defects or the use of tissue flaps to ensure proper healing and function, particularly to maintain swallowing capabilities and prevent aspiration. Overall, the pharyngoesophageal repair is a complex procedure that requires meticulous surgical technique and a thorough understanding of the anatomy involved.
© Copyright 2025 Coding Ahead. All rights reserved.
The pharyngoesophageal repair procedure (CPT® Code 42953) is indicated for various conditions that result in defects or malformations of the pharynx and cervical esophagus. These indications may include:
The pharyngoesophageal repair procedure involves several critical steps to ensure effective repair of the pharynx and esophagus. The procedure is initiated with an incision in the skin of the neck, which may be an apron-type incision in a skin fold or a vertical incision anterior to the sternocleidomastoid muscles. This incision allows for adequate exposure of the underlying structures. The surgeon then retracts the sternocleidomastoid muscles laterally and rotates the strap muscles and larynx medially to gain access to the pharynx. Following this, the tissue plane behind the pharynx and anterior to the cervical spine is carefully dissected to expose the posterior aspect of the pharynx. A thorough inspection of the pharynx is conducted to assess the extent and type of repair needed. The surgical site is then flushed with sterile saline to remove any debris, and any necrotic tissue is debrided to prepare for repair. The edges of the pharyngeal injury are trimmed to facilitate a clean closure. If the procedure involves the pharynx alone, a direct repair may be performed. However, if the repair includes the cervical esophagus, the esophagus is also mobilized and evaluated for injuries. Depending on the severity of the defects, the surgeon may opt for a layered closure of the mucosa followed by the muscular layer or utilize a myocutaneous or other tissue flap for reconstruction. Drains may be placed in the neck as necessary, and the overlying tissues and skin are repaired in layers to ensure proper healing.
After the pharyngoesophageal repair procedure, patients typically require careful monitoring and post-operative care to ensure proper healing and recovery. This may include managing any drains placed during surgery and monitoring for signs of infection or complications. Patients may also need to follow specific dietary guidelines, often starting with a liquid diet and gradually progressing to solid foods as tolerated. Follow-up appointments are essential to assess the healing process and the functionality of the pharynx and esophagus. The healthcare team will provide instructions on wound care and any necessary restrictions on activities during the recovery period.
| Short Descr | REPAIR THROAT ESOPHAGUS | Medium Descr | PHARYNGOESOPHAGEAL REPAIR | Long Descr | Pharyngoesophageal repair | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 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). | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.