How To Use CPT Code 43100

CPT 43100 describes the excision of a lesion from the esophagus using a cervical approach with primary repair. 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 43100?

CPT 43100 can be used to describe the surgical procedure in which a qualified healthcare provider removes a lesion from the esophagus using a cervical approach. This code specifically refers to cases where the provider performs primary repair after excising the lesion.

2. Official Description

The official description of CPT code 43100 is: ‘Excision of lesion, esophagus, with primary repair; cervical approach.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. Using a lateral or oblique incision in the neck, the provider carefully dissects the tissues to access the esophagus.
3. The provider identifies the lesion and examines the surrounding tissues.
4. Using a scalpel, the provider excises the lesion.
5. The provider then performs primary repair of the esophagus, suturing the layers together.
6. Finally, the provider closes the skin incision.

4. Qualifying circumstances

CPT 43100 is applicable when a patient requires the excision of a lesion from the esophagus using a cervical approach. The procedure must involve primary repair of the esophagus. The patient’s condition and medical necessity must be documented to support the use of this code.

5. When to use CPT code 43100

CPT code 43100 should be used when a qualified healthcare provider performs the excision of a lesion from the esophagus using a cervical approach and performs primary repair. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 43100, the healthcare provider must document the following information:

• Patient’s diagnosis and medical necessity for the procedure
• Details of the cervical approach used
• Description of the lesion and its location
• Procedure start and end times
• Details of the primary repair performed
• Any additional relevant information or complications

7. Billing guidelines

When billing for CPT 43100, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately report the approach used and document the primary repair performed. Consider any additional guidelines or modifiers that may be applicable based on payer requirements.

8. Historical information

CPT 43100 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. However, it is important to stay updated with any changes or revisions that may occur in the future.

9. Examples

1. A surgeon performs the excision of a lesion from the esophagus using a cervical approach and performs primary repair.
2. A gastroenterologist removes a lesion from the esophagus through a cervical incision and performs primary repair.
3. An otolaryngologist excises a lesion from the esophagus using a cervical approach and performs primary repair.
4. A general surgeon performs the excision of a lesion from the esophagus through a lateral incision in the neck and performs primary repair.
5. A thoracic surgeon removes a lesion from the esophagus using an oblique incision in the neck and performs primary repair.
6. A surgical oncologist excises a lesion from the esophagus using a cervical approach and performs primary repair.
7. An ENT specialist removes a lesion from the esophagus through a cervical incision and performs primary repair.
8. A head and neck surgeon excises a lesion from the esophagus using a cervical approach and performs primary repair.
9. A cardiothoracic surgeon removes a lesion from the esophagus through a lateral incision in the neck and performs primary repair.
10. A gastrointestinal surgeon excises a lesion from the esophagus using an oblique incision in the neck and performs primary repair.