How To Use CPT Code 21743

CPT code 21743 describes the reconstructive repair of pectus excavatum or carinatum using a minimally invasive approach known as the Nuss procedure, with the assistance of thoracoscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 21743?

CPT code 21743 is used to describe the reconstructive repair of pectus excavatum or carinatum, which are congenital deformities of the chest wall. This procedure is performed using a minimally invasive approach called the Nuss procedure, with the assistance of thoracoscopy. The provider makes small incisions and uses endoscopic equipment to create a tunnel between the incisions. A previously shaped steel bar is then inserted into the retrosternal space and through the tunnel to correct the deformity. The bar is secured to the chest wall fascia, and the incisions are closed with sutures.

2. Official Description

The official description of CPT code 21743 is: ‘Reconstructive repair of pectus excavatum or carinatum minimally invasive approach (Nuss procedure), with thoracoscopy.’

3. Procedure

1. The provider makes two small skin incisions along the midaxillary line on both sides of the sternum.
2. Using endoscopic equipment, the provider creates a tunnel between the two incisions and moves through the tunnel to the sternum.
3. A thoracoscope is inserted into the right pleural space to view the procedure.
4. A previously shaped steel bar is passed into the retrosternal space and through the tunnel.
5. The provider rotates the bar to correct the deformity.
6. The bar is secured to the chest wall fascia using sutures.
7. The skin incisions are closed with sutures.

4. Qualifying circumstances

CPT code 21743 is used for patients with congenital deformities of the chest wall, specifically pectus excavatum (sunken chest deformity) or pectus carinatum (protruding sternum deformity). The procedure is performed using a minimally invasive approach, known as the Nuss procedure, with the assistance of thoracoscopy. It is important to note that this code is specific to the repair of pectus excavatum or carinatum and should not be used for other chest wall deformities or procedures.

5. When to use CPT code 21743

CPT code 21743 should be used when a provider performs a reconstructive repair of pectus excavatum or carinatum using the Nuss procedure and thoracoscopy. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of a minimally invasive approach and the assistance of thoracoscopy.

6. Documentation requirements

To support a claim for CPT code 21743, the provider must document the following information:

• Patient’s diagnosis of pectus excavatum or carinatum
• Description of the procedure performed, including the use of the Nuss procedure and thoracoscopy
• Date of the procedure
• Details of the incisions made and the placement of the steel bar
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 21743, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of a minimally invasive approach and the assistance of thoracoscopy are key components of this code. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT code 21743 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 21743

There are no similar codes to CPT code 21743 within the range of repair, revision, and/or reconstruction procedures on the neck (soft tissues) and thorax (21685-21750).

9. Examples

1. A provider performs a reconstructive repair of pectus excavatum using the Nuss procedure and thoracoscopy for a patient with a sunken chest deformity.
2. A patient with a protruding sternum deformity undergoes a reconstructive repair using the Nuss procedure and thoracoscopy.
3. A provider corrects a congenital chest wall deformity in a patient using the minimally invasive approach of the Nuss procedure and thoracoscopy.
4. A teenager with pectus excavatum undergoes a minimally invasive repair using the Nuss procedure and thoracoscopy to correct the chest wall deformity.
5. A provider performs a reconstructive repair of pectus carinatum using the Nuss procedure and thoracoscopy for a patient with a protruding sternum deformity.
6. A child with a sunken chest deformity undergoes a minimally invasive repair using the Nuss procedure and thoracoscopy to correct the chest wall deformity.
7. A provider uses the Nuss procedure and thoracoscopy to correct a congenital chest wall deformity in a patient with pectus excavatum.
8. A teenager with pectus carinatum undergoes a reconstructive repair using the Nuss procedure and thoracoscopy to correct the protruding sternum deformity.
9. A provider performs a minimally invasive repair of pectus excavatum using the Nuss procedure and thoracoscopy for a patient with a sunken chest deformity.
10. A child with a protruding sternum deformity undergoes a reconstructive repair using the Nuss procedure and thoracoscopy to correct the chest wall deformity.