© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 43286 refers to a total or near total esophagectomy, which is a surgical operation involving the removal of a significant portion of the esophagus. This procedure is performed using laparoscopic techniques, which involve the use of small incisions and specialized instruments to minimize trauma to the body. The operation includes the mobilization of both the abdominal and mediastinal esophagus, as well as a proximal gastrectomy, which is the surgical removal of the upper part of the stomach. If indicated, a laparoscopic pyloric drainage procedure may also be performed during this operation. The esophagectomy is often indicated for patients suffering from esophageal diseases, including carcinoma, where the esophagus is compromised. The laparoscopic approach allows for a less invasive method of surgery, which can lead to reduced recovery times and less postoperative pain compared to traditional open surgery. The procedure may also involve an open cervical pharyngogastrostomy or esophagogastrostomy, which are techniques used to create a new connection between the remaining esophagus or stomach and the pharynx, facilitating the passage of food. During the procedure, various anatomical structures are carefully manipulated and preserved, including the gastric vessels and lymph nodes, to ensure optimal outcomes and minimize complications. The use of laparoscopic instruments allows for precise dissection and mobilization of the esophagus and stomach, ultimately leading to the creation of a gastric conduit that will replace the esophagus. This complex surgical intervention requires a high level of skill and expertise, as it involves critical structures in the neck and chest, necessitating careful dissection to avoid damage to surrounding tissues and nerves.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 43286 is indicated for the treatment of various esophageal diseases, particularly in cases of carcinoma or other significant pathologies affecting the esophagus. The following conditions may warrant the performance of a total or near total esophagectomy:
The procedure for CPT® Code 43286 involves several critical steps, each designed to ensure the successful removal of the esophagus and reconstruction of the gastrointestinal tract:
After the completion of the esophagectomy, patients typically require careful monitoring and postoperative care. Expected recovery may involve a hospital stay for several days, during which time the surgical site will be observed for any signs of complications such as infection or leakage from the anastomosis. Patients may be started on a modified diet, gradually progressing from clear liquids to soft foods as tolerated. The nasogastric tube, if placed, will be monitored and may be removed once the patient is able to tolerate oral intake. Follow-up appointments will be necessary to assess healing and manage any ongoing symptoms related to the surgery.
| Short Descr | ESPHG TOT W/LAPS MOBLJ | Medium Descr | ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ | Long Descr | Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy) | 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) | none | MUE | 1 |
| 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. | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2018-01-01 | Added | Code Added. |
Get instant expert-level medical coding assistance.