How To Use CPT Code 39200

CPT 39200 describes the resection of a mediastinal cyst, a procedure performed by a healthcare provider to remove a cyst located in the mediastinum. This article will provide an overview of CPT code 39200, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 39200?

CPT 39200 is used to describe the resection of a mediastinal cyst, which involves the removal of a cyst located in the mediastinum. The mediastinum is the mass of tissues and organs in the middle of the chest between the lungs. The procedure is performed by a healthcare provider who makes an incision either in the thorax or the sternum to access the mediastinum and remove the cyst.

2. Official Description

The official description of CPT code 39200 is: ‘Resection of mediastinal cyst.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider positions the patient for either a median sternotomy incision or a thoracotomy, depending on the location of the cyst.
3. If a thoracotomy is performed, the provider incises the ribs and may use a rib spreader to access the target area. If a median sternotomy incision is chosen, the provider makes a vertical incision along the sternum and splits the sternal bone to access the mediastinum.
4. The provider carefully inspects the mediastinum for any signs of disease and identifies the cyst either through prior radiographic imaging or during exploration.
5. The cyst is resected, or removed, by the provider.
6. After the procedure is complete, the provider closes the incision site by reapproximating the tissue between the ribs in layers for a thoracotomy approach or wiring the sternum together and closing the soft tissue in layers over the bone for a median sternotomy incision.

4. Qualifying circumstances

CPT 39200 is performed on patients who have a mediastinal cyst that requires resection. A mediastinal cyst is a closed, saclike area within the mediastinum that may contain liquid, gaseous, or semisolid substances. The cyst can be benign or malignant and can be found in various locations within the mediastinum. The procedure is performed by a healthcare provider who is qualified to perform surgical interventions.

5. When to use CPT code 39200

CPT code 39200 should be used when a healthcare provider performs the resection of a mediastinal cyst. It is important to ensure that the procedure performed meets the specific criteria outlined in the code description. If the procedure performed does not involve the resection of a mediastinal cyst, a different code should be used to accurately represent the service provided.

6. Documentation requirements

To support a claim for CPT code 39200, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of a mediastinal cyst
• Description of the procedure performed, including the approach used (thoracotomy or median sternotomy)
• Details of the cyst resection, including any complications or additional findings
• Incision site closure method
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 39200, it is important to ensure that the procedure performed meets the specific criteria outlined in the code description. The healthcare provider should use the appropriate code based on the specific procedure performed. It is also important to follow any additional guidelines provided by payers or regulatory bodies to ensure accurate billing and reimbursement.

8. Historical information

CPT code 39200 was added to the Current Procedural Terminology system on January 1, 1990. The code description was changed on January 1, 2012, from ‘Excision of mediastinal cyst’ to ‘Resection of mediastinal cyst.’ In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A healthcare provider performs the resection of a mediastinal cyst in a patient with a benign cyst located in the anterior mediastinum.
2. A patient undergoes the resection of a mediastinal cyst through a thoracotomy approach due to the presence of a malignant cyst in the posterior mediastinum.
3. A healthcare provider performs the resection of a mediastinal cyst in a patient with a large cyst causing compression of adjacent structures in the mediastinum.
4. A patient undergoes the resection of a mediastinal cyst through a median sternotomy incision to remove a cyst located in the middle mediastinum.
5. A healthcare provider performs the resection of a mediastinal cyst in a patient with a recurrent cyst that has previously been drained but requires complete removal.
6. A patient undergoes the resection of a mediastinal cyst through a thoracotomy approach to relieve symptoms caused by the cyst’s pressure on surrounding organs.
7. A healthcare provider performs the resection of a mediastinal cyst in a patient with a cystic mass identified on radiographic imaging and confirmed during exploration.
8. A patient undergoes the resection of a mediastinal cyst through a median sternotomy incision to remove a cyst causing respiratory symptoms and chest pain.
9. A healthcare provider performs the resection of a mediastinal cyst in a patient with a large cystic mass that is suspected to be malignant based on imaging findings.
10. A patient undergoes the resection of a mediastinal cyst through a thoracotomy approach to remove a cyst causing compression of the trachea and difficulty breathing.