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Esophagoplasty is a surgical procedure that involves the plastic repair or reconstruction of the esophagus, which is the muscular tube that connects the throat to the stomach. This procedure is typically indicated for various conditions that may compromise the integrity of the esophagus, such as blunt trauma, avulsion injuries, or complications arising from tracheoesophageal fistulas. The surgery is performed through a cervical approach, meaning that an incision is made in the neck, usually on the left side, to access the esophagus directly. During the procedure, critical structures such as the internal jugular vein and carotid artery are carefully identified and retracted to provide a clear view of the trachea and esophagus. The surgeon makes an incision in the cervical esophagus, either above or below the lesion, to address the defect. It is important to note that in the context of CPT® Code 43300, the procedure does not involve the repair of a tracheoesophageal fistula, which distinguishes it from related procedures like CPT® Code 43305. The esophagus is meticulously dissected from surrounding tissues to allow for thorough inspection and repair of the defect. Any damaged or necrotic tissue is removed, and the mucosal layer is prepared for suturing. The repair is performed in layers, with the mucosal tissue being inverted and sutured, followed by a second layer of sutures placed in the muscular wall of the esophagus. This careful approach ensures the structural integrity of the esophagus is restored, facilitating proper function and reducing the risk of complications.
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Esophagoplasty is performed for specific indications related to the structural integrity and functionality of the esophagus. The following conditions may warrant this surgical intervention:
The esophagoplasty procedure involves several critical steps to ensure effective repair of the esophagus. The following procedural steps outline the process:
After the esophagoplasty procedure, patients typically require careful monitoring and post-operative care to ensure proper healing. Expected recovery may involve a hospital stay where the patient is observed for any complications. Pain management and nutritional support are essential during the initial recovery phase, as the esophagus heals. Patients may need to follow a specific diet, gradually transitioning from liquids to soft foods as tolerated. Follow-up appointments are crucial to assess the healing process and to ensure that the esophagus is functioning properly. Any signs of complications, such as infection or issues with swallowing, should be promptly addressed by the healthcare team.
| Short Descr | REPAIR OF ESOPHAGUS | Medium Descr | ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL | Long Descr | Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient 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). | 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. | 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 |
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| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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