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The CPT® Code 43100 refers to the surgical procedure involving the excision of a lesion located in the esophagus, specifically utilizing a cervical approach. This procedure is performed when there is a need to remove an abnormal growth or lesion from the esophagus, which may be causing symptoms or posing a risk to the patient's health. The cervical approach indicates that the incision is made in the neck region, allowing direct access to the esophagus. During the procedure, the physician carefully identifies and retracts critical structures such as the internal jugular vein and carotid artery to ensure a clear view and safe working environment. The surgeon then makes an incision in the cervical esophagus, either above or below the lesion, to expose it adequately. The lesion is excised along with a margin of healthy tissue to ensure complete removal, and the excised tissue is sent for histologic evaluation to assess its nature. After the lesion is removed, the esophagus is repaired using sutures, and the cervical incision is meticulously closed in layers to promote proper healing. This procedure is essential for addressing esophageal lesions that may require surgical intervention, and it is critical for the overall management of the patient's condition.
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The procedure described by CPT® Code 43100 is indicated for the excision of lesions in the esophagus that may be causing symptoms or are suspected to be malignant. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 43100 involves several critical steps to ensure the successful excision of the esophageal lesion:
Post-procedure care following the excision of an esophageal lesion via the cervical approach includes monitoring for any complications such as bleeding, infection, or issues related to esophageal function. Patients may be advised to follow a specific diet and may require follow-up appointments to assess healing and the results of the histologic evaluation. Pain management and wound care instructions are also provided to ensure a smooth recovery process.
| Short Descr | EXCISION OF ESOPHAGUS LESION | Medium Descr | EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR | Long Descr | Excision of lesion, esophagus, with primary repair; cervical approach | 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 | 94 - Other OR upper GI therapeutic procedures |
| 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. | 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). | 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. | 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 |
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| Pre-1990 | Added | Code added. |
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