© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 43360 refers to a surgical procedure known as gastrointestinal reconstruction, specifically performed following a previous esophagectomy. This procedure is indicated for patients who have obstructing esophageal lesions, fistulas, or have undergone esophageal exclusion. The primary goal of this reconstruction is to create a new passage for food from the stomach to the remaining esophagus or pharynx, effectively replacing the esophagus that has been removed or rendered non-functional. The procedure involves meticulous surgical techniques to ensure that the newly formed gastric tube has an adequate blood supply and is properly connected to the digestive tract. The reconstruction utilizes a segment of the stomach, which is fashioned into a tube that can serve as a substitute for the esophagus, allowing for the continuation of normal digestive processes. This complex operation may also include pyloroplasty, which is performed to alleviate any strictures in the duodenum, thereby facilitating better passage of food through the gastrointestinal tract.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 43360 is indicated for the following conditions:
The procedure for gastrointestinal reconstruction as per CPT® Code 43360 involves several detailed steps:
Post-procedure care following the gastrointestinal reconstruction involves monitoring the patient for any complications related to the surgery. Patients may require a period of recovery in a hospital setting to ensure that the new gastric tube is functioning properly and that there are no signs of infection or leakage at the anastomosis site. Nutritional support may be necessary, and patients are typically advised on dietary modifications to accommodate the changes in their digestive system. Follow-up appointments will be essential to assess the healing process and the effectiveness of the reconstruction.
| Short Descr | GASTROINTESTINAL REPAIR | Medium Descr | GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH | Long Descr | Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty | 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. | 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.) | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1995-01-01 | Added | First appearance in code book in 1995. |
Get instant expert-level medical coding assistance.