© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 43107 refers to a surgical procedure known as a total or near total esophagectomy performed without thoracotomy, specifically utilizing a transhiatal approach. This technique involves accessing the esophagus through an incision made in the upper abdomen rather than through the chest, which is referred to as thoracotomy. The primary goal of this procedure is to remove the esophagus, which may be necessary due to various conditions such as esophageal cancer, severe esophageal dysmotility, or other significant esophageal diseases. During the surgery, the stomach is mobilized and prepared to create a new passage for food intake, which is achieved through a pharyngogastrostomy or cervical esophagogastrostomy. This procedure may also include a pyloroplasty, which is a surgical modification of the pylorus to facilitate gastric drainage. The transhiatal approach is preferred in many cases to minimize complications associated with thoracic incisions, such as mediastinitis, which can arise from leaks in the esophagus. Overall, this procedure is complex and requires careful dissection and reconstruction to ensure proper healing and function post-surgery.
© Copyright 2025 Coding Ahead. All rights reserved.
The total or near total esophagectomy, CPT® Code 43107, is indicated for several specific conditions and symptoms that necessitate the removal of the esophagus. These include:
The procedure for a total or near total esophagectomy using CPT® Code 43107 involves several critical steps, which are detailed as follows:
After the total or near total esophagectomy, patients typically require careful monitoring and management to ensure proper recovery. Post-procedure care may include the following considerations:
Patients are usually observed for any signs of complications, such as leaks at the anastomosis site or infection. Nutritional support may be necessary, often starting with intravenous fluids and gradually transitioning to oral intake as tolerated. Follow-up imaging may be performed to assess the integrity of the anastomosis and the overall healing process. Additionally, patients may need to be educated on dietary modifications and swallowing techniques to adapt to their new gastrointestinal configuration. Regular follow-up appointments are essential to monitor recovery and address any potential issues that may arise during the healing process.
| Short Descr | REMOVAL OF ESOPHAGUS | Medium Descr | TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY | Long Descr | Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) | 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 |
| 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 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). | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1995-01-01 | Added | First appearance in code book in 1995. |
Get instant expert-level medical coding assistance.