© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 43340 is known as esophagojejunostomy performed via an abdominal approach. This surgical intervention is typically indicated when there has been a prior surgical removal of the stomach, such as in cases where an esophagogastrojejunostomy has failed. The failure may necessitate the excision of an ischemic segment of the jejunum, which is then re-anastomosed to the esophagus. The abdominal approach, also referred to as a transhiatal approach, involves making an incision in the upper abdomen to explore the peritoneal cavity. This allows the surgeon to access the lower posterior mediastinum and distal esophagus effectively. The procedure is critical for restoring continuity between the esophagus and the jejunum, particularly in patients who have undergone significant gastrointestinal surgeries that compromise normal digestive pathways.
© Copyright 2025 Coding Ahead. All rights reserved.
The esophagojejunostomy procedure (CPT® Code 43340) is indicated in specific clinical scenarios, particularly when previous surgical interventions have not yielded successful outcomes. The following conditions may warrant this procedure:
The esophagojejunostomy procedure involves several detailed steps to ensure successful re-anastomosis of the jejunum to the esophagus. The following procedural steps are performed:
After the esophagojejunostomy procedure, patients typically require careful monitoring and post-operative care. Expected recovery may involve managing pain, monitoring for any signs of complications such as infection or anastomotic leaks, and ensuring proper nutrition as the patient adjusts to changes in their digestive system. Follow-up appointments are essential to assess the healing process and the functionality of the anastomosis. Additionally, if a chest tube was placed, it will need to be monitored and managed appropriately until it can be safely removed.
| Short Descr | FUSE ESOPHAGUS & INTESTINE | Medium Descr | ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR | Long Descr | Esophagojejunostomy (without total gastrectomy); 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 |
| 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). | 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. | 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.) | 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). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.