How To Use CPT Code 43124

CPT 43124 describes the procedure of total or partial esophagectomy without reconstruction, including cervical esophagostomy. This article will cover the description, official definition, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43124?

CPT 43124 is used to describe the surgical procedure of removing all or part of the esophagus without reconstructing it. The provider also performs cervical esophagostomy, which involves connecting the remaining upper portion of the esophagus to an opening in the neck. This procedure is typically performed to treat conditions such as esophageal cancer, severe damage from caustic fluids, or spontaneous ruptures of the esophagus.

2. Official Description

The official description of CPT code 43124 is: ‘Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes one or more incisions in the neck, chest, or abdomen.
3. The provider inspects the esophagus and determines the length of esophagus to be removed.
4. The provider incises the esophagus free of its supports and removes it, either in whole or in part.
5. The provider stitches the cut ends of the esophagus and stomach to close them without reconstructing a route from the esophagus to the stomach.
6. The provider creates a cervical esophagostomy, connecting the remaining upper end of the esophagus to an opening in the neck.
7. The provider connects the opening to an appliance that allows fluids from the mouth and nose to drain outside the body.
8. The provider inspects the wound and closes the incision in layers.

4. Qualifying circumstances

CPT 43124 is performed on patients who require the removal of all or part of the esophagus without reconstruction. This procedure is typically indicated for patients with esophageal cancer, severe damage from caustic fluids, or spontaneous ruptures of the esophagus. The provider must assess the patient’s condition and determine the need for esophagectomy.

5. When to use CPT code 43124

CPT code 43124 should be used when the provider performs a total or partial esophagectomy without reconstruction, including cervical esophagostomy. This code accurately represents the specific procedure performed and should be reported accordingly.

6. Documentation requirements

To support a claim for CPT 43124, the provider must document the following information:

• Patient’s diagnosis and the need for esophagectomy
• Details of the procedure, including the approach used (neck, chest, or abdomen)
• Length of esophagus removed
• Description of the cervical esophagostomy
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 43124, ensure that the procedure performed matches the description of the code. The provider should use the appropriate approach (neck, chest, or abdomen) based on the specific case. It is important to follow the guidelines set by the payer and accurately document the procedure to support the claim.

8. Historical information

CPT 43124 was added to the Current Procedural Terminology system on January 1, 1995. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with esophageal cancer undergoes a total esophagectomy without reconstruction, including cervical esophagostomy.
2. A patient with severe damage from caustic fluids requires a partial esophagectomy without reconstruction, including cervical esophagostomy.
3. A patient with a spontaneous rupture of the esophagus undergoes a total esophagectomy without reconstruction, including cervical esophagostomy.
4. A patient with a large esophageal tumor undergoes a partial esophagectomy without reconstruction, including cervical esophagostomy.
5. A patient with a history of esophageal strictures requires a total esophagectomy without reconstruction, including cervical esophagostomy.
6. A patient with Barrett’s esophagus undergoes a partial esophagectomy without reconstruction, including cervical esophagostomy.
7. A patient with a recurrent esophageal tumor requires a total esophagectomy without reconstruction, including cervical esophagostomy.
8. A patient with a perforated esophagus undergoes a partial esophagectomy without reconstruction, including cervical esophagostomy.
9. A patient with a large hiatal hernia requires a total esophagectomy without reconstruction, including cervical esophagostomy.
10. A patient with a history of esophageal strictures undergoes a partial esophagectomy without reconstruction, including cervical esophagostomy.