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The CPT® Code 43401 refers to the surgical procedure known as transection of the esophagus with repair, specifically performed for the treatment of esophageal varices. Esophageal varices are enlarged veins in the esophagus that can rupture and cause significant bleeding, often associated with liver disease. This procedure is typically indicated in cases where less invasive treatments, such as pharmacologic therapy or endoscopic interventions, have failed to control variceal bleeding. The approach to this surgery involves a right posterolateral thoracotomy, which is a surgical incision made in the chest to access the esophagus. The skin is incised, and the incision is extended through the soft tissues, allowing for the retraction of the scapula and entry into the thoracic cavity without damaging the pleura. In some cases, a transhiatal abdominal approach may be utilized instead. The procedure involves careful dissection to expose the distal third of the esophagus, where the varices are located. The surgeon then transects the esophagus using a staple gun, which effectively devascularizes the varices, thereby controlling the bleeding. Following the transection, the esophagus is repaired, and the surgical incisions are closed, marking the completion of the procedure.
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The procedure described by CPT® Code 43401 is indicated for patients experiencing severe complications from esophageal varices, particularly in situations where variceal bleeding cannot be effectively managed through pharmacologic or endoscopic methods. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 43401 involves several critical steps to ensure effective treatment of esophageal varices:
Post-procedure care following the transection of the esophagus with repair involves monitoring the patient for any signs of complications, such as infection or bleeding. Patients may require supportive care, including pain management and nutritional support, as they recover from the surgery. The expected recovery period can vary based on the individual patient's health status and the complexity of the procedure. Follow-up appointments are essential to assess healing and ensure that the esophageal varices do not recur.
| Short Descr | ESOPHAGUS SURGERY FOR VEINS | Medium Descr | TRNSXJ ESOPH W/RPR ESOPHAGEAL VARICES | Long Descr | Transection of esophagus with repair, for esophageal varices | 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 | Not applicable/unspecified. | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
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| 2019-12-31 | Deleted | Code deleted. |
| Pre-1990 | Added | Code added. |
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