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The CPT® Code 43101 refers to the surgical procedure involving the excision of a lesion located in the esophagus, accompanied by primary repair. This procedure can be performed through either a thoracic or abdominal approach, depending on the specific location of the lesion within the esophagus. The primary goal of this surgery is to remove the lesion along with a margin of healthy tissue to ensure complete excision and to facilitate proper healing. The excised tissue is typically sent for histologic evaluation to assess any pathological conditions. The procedure requires careful dissection and exposure of the esophagus, which may involve retraction of surrounding structures such as the lung or diaphragm. After the lesion is removed, the esophagus is meticulously repaired using sutures, and the surgical incision is closed in layers to promote optimal recovery and minimize complications. This code is essential for accurately documenting and billing for the surgical intervention performed on the esophagus.
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The procedure coded under CPT® 43101 is indicated for the excision of lesions in the esophagus that may be causing symptoms or have the potential for malignancy. The specific indications for this procedure include:
The procedure for CPT® 43101 involves several critical steps, which are detailed as follows:
Post-procedure care following the excision of an esophageal lesion includes monitoring for any complications such as bleeding, infection, or anastomotic leaks. Patients may require a period of hospitalization for observation and management of pain. Dietary modifications may be necessary, with a gradual reintroduction of oral intake as tolerated. Follow-up appointments are essential to assess healing and to review the histologic findings from the excised tissue. Additional treatments may be indicated based on the pathology results.
| Short Descr | EXCISION OF ESOPHAGUS LESION | Medium Descr | EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR | Long Descr | Excision of lesion, esophagus, with primary repair; thoracic or abdominal 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 |
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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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