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A diverticulectomy of the hypopharynx or esophagus is a surgical procedure aimed at removing a diverticulum, which is an abnormal sac or pouch that can form in the wall of these tubular organs. Diverticula can be either congenital, present at birth, or acquired due to various factors. One common type of acquired diverticulum in the hypopharynx is known as a Zenker diverticulum, which occurs when the mucosal lining herniates through a weak area in the posterior wall of the hypopharynx. While diverticula in the esophagus are less common, they typically develop in the middle or lower sections of the esophagus. The procedure can be performed using different surgical approaches, with the thoracic approach being utilized in this specific code (CPT® 43135). This approach involves accessing the esophagus through a right posterior thoracotomy, which allows for direct visualization and manipulation of the diverticulum. The surgical technique requires careful dissection and mobilization of the esophagus or hypopharynx to ensure complete excision of the diverticulum, which is characterized by a mucosal outpouching in the muscular wall. The procedure may also include a myotomy, which is the surgical incision of the muscle, performed on the side opposite to the diverticulum to alleviate any associated symptoms or complications.
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The diverticulectomy of the hypopharynx or esophagus is indicated for the following conditions:
The procedure for diverticulectomy of the hypopharynx or esophagus involves several critical steps to ensure successful removal of the diverticulum:
Post-procedure care following a diverticulectomy includes monitoring for complications such as bleeding, infection, or leakage at the surgical site. Patients may require a period of hospitalization for observation and management of any immediate postoperative issues. Recovery typically involves a gradual return to normal diet, starting with clear liquids and progressing to soft foods as tolerated. Follow-up appointments are essential to assess healing and ensure that the patient is recovering appropriately. Additionally, patients may be advised on lifestyle modifications to prevent recurrence of symptoms associated with diverticula.
| Short Descr | REMOVAL OF ESOPHAGUS POUCH | Medium Descr | DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR | Long Descr | Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic 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 |
| 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. | 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 | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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