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The CPT® Code 43361 refers to a complex 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 reconstruction can involve the use of either a section of the colon or the small intestine, which is selected based on the specific clinical scenario and the surgeon's assessment. The procedure entails several critical steps, including the mobilization and preparation of the intestine or colon, as well as the creation of anastomoses, which are surgical connections between the segments of the gastrointestinal tract. The complexity of the procedure is underscored by the need to preserve blood supply to the graft, ensuring adequate perfusion, and the potential requirement for additional surgical interventions, such as enlarging the thoracic inlet or performing a median sternotomy, to facilitate access to the anastomosis site. Overall, this procedure aims to restore gastrointestinal continuity and function in patients who have experienced significant esophageal pathology.
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The procedure described by CPT® Code 43361 is indicated for the following conditions:
The procedure involves several detailed steps to ensure successful gastrointestinal reconstruction:
Post-procedure care involves monitoring the patient for complications and ensuring proper recovery. Patients may require nutritional support through the jejunostomy tube until they can resume normal oral intake. Close observation for signs of infection, anastomotic leaks, or other complications is essential. Follow-up imaging or endoscopy may be necessary to assess the integrity of the anastomosis and the overall function of the gastrointestinal tract. The recovery process may vary based on the individual patient's condition and the extent of the surgical intervention.
| Short Descr | GASTROINTESTINAL REPAIR | Medium Descr | GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT | Long Descr | Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es) | 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. | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2002-01-01 | Changed | Code description changed. |
| 1995-01-01 | Added | First appearance in code book in 1995. |
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