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The procedure described by CPT® Code 43341 is known as esophagojejunostomy performed via a thoracic approach. This surgical intervention is typically indicated when the stomach has been previously removed, often due to complications from earlier surgeries such as esophagogastrojejunostomy. In cases where the initial procedure has failed, it may become necessary to excise an ischemic segment of the jejunum and re-establish a connection to the esophagus. The thoracic approach, specifically a right posterior thoracotomy, allows for direct access to the distal esophagus and abdominal contents. This method is distinct from the abdominal approach outlined in CPT® Code 43340, which involves an incision in the upper abdomen and exploration of the peritoneal cavity. The thoracic approach is particularly beneficial in cases where access to the esophagus is required without disrupting the pleura, thereby minimizing complications associated with lung injury. The procedure involves careful dissection and manipulation of the jejunum to ensure proper vascular supply is maintained, ultimately facilitating a successful anastomosis between the esophagus and the jejunum.
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The esophagojejunostomy procedure (CPT® Code 43341) 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 critical steps, each designed to ensure a successful surgical outcome. The following outlines the procedural steps involved:
After the esophagojejunostomy procedure, patients typically require careful monitoring and management. Post-operative care may include the management of any chest tubes placed during surgery, monitoring for signs of infection, and ensuring that the anastomosis is healing properly. Patients may also need to follow a specific diet as they recover, gradually transitioning from intravenous nutrition to oral intake as tolerated. The expected recovery period can vary based on individual patient factors and the complexity of the surgery, but close follow-up with the surgical team is essential to address any complications that may arise during the healing process.
| Short Descr | FUSE ESOPHAGUS & INTESTINE | Medium Descr | ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR | Long Descr | Esophagojejunostomy (without total gastrectomy); 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). | 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. | 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). |
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| Pre-1990 | Added | Code added. |
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