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An esophagotomy is a surgical procedure that involves making an incision in the esophagus, which is the tube that carries food from the throat to the stomach. This specific procedure, identified by CPT® Code 43020, is performed through a cervical approach, meaning the incision is made in the neck area. The primary purpose of this procedure is to remove a foreign body that has become incarcerated or impacted within the esophagus. Such foreign bodies can include food items, bones, or other objects that may obstruct the esophagus and cause significant discomfort or potential injury. During the procedure, the surgeon typically makes an incision on the left side of the neck, carefully identifies and retracts vital structures such as the internal jugular vein and carotid artery to gain access to the esophagus. Once the esophagus is exposed, an incision is made directly at the site of the foreign body, allowing for its removal. After the foreign body is extracted, the surgeon inspects the esophagus for any signs of tearing or injury, performing repairs as necessary to ensure the integrity of the esophagus. Finally, the esophageal incision is closed, and the neck is sutured in layers to promote proper healing.
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The esophagotomy procedure, coded as CPT® 43020, is indicated in specific clinical scenarios where a foreign body has become lodged in the esophagus, leading to potential complications. The following conditions warrant the performance of this procedure:
The esophagotomy procedure involves several critical steps to ensure the safe removal of the foreign body. Each step is essential for the successful outcome of the surgery:
After the esophagotomy procedure, patients typically require monitoring for any signs of complications, such as infection or leakage from the esophagus. Post-operative care may include pain management, dietary modifications, and follow-up appointments to assess healing. Patients are often advised to start with a liquid diet and gradually progress to solid foods as tolerated, depending on the surgeon's recommendations. It is essential to monitor the surgical site for any signs of abnormal swelling or discharge, and patients should be educated on the importance of reporting any concerning symptoms to their healthcare provider promptly.
| Short Descr | INCISION OF ESOPHAGUS | Medium Descr | ESOPHAGOTOMY CERVICAL APPR W/RMVL FB | Long Descr | Esophagotomy, cervical approach, with removal of foreign body | 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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