How To Use CPT Code 43340

CPT 43340 describes the surgical procedure known as esophagojejunostomy, which involves the creation of an artificial communication between the esophagus and the jejunum. This article will provide an overview of CPT code 43340, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43340?

CPT 43340 is a code used to describe the surgical procedure called esophagojejunostomy. This procedure involves the creation of an artificial connection between the esophagus and the jejunum, which is the second part of the small intestine. It is typically performed through an abdominal incision, and it aims to ensure an uninterrupted gastrointestinal tract for the patient.

2. Official Description

The official description of CPT code 43340 is: ‘Esophagojejunostomy (without total gastrectomy); abdominal approach.’

3. Procedure

1. During the procedure, the healthcare provider makes an upper abdominal incision to access the esophagus, stomach, and jejunum.
2. The provider then removes the affected portion of the esophagus and the lower part of the stomach.
3. In the chest, the provider sutures the remaining part of the stomach to the esophagus and connects the upper jejunum to this structure.
4. If necessary, the provider may also repair the jejunum if there was a previous jejunostomy for feeding.
5. The procedure may also involve connecting part of the duodenum, the first part of the small intestine, to the jejunum and closing the other end of the duodenum.
6. The provider ensures hemostasis and may check for anastomotic leaks using dye or air.
7. Finally, the incision is closed in layers.

4. Qualifying circumstances

CPT 43340 is typically performed on patients who require an esophagojejunostomy without the need for a total gastrectomy. The procedure is indicated for patients with specific conditions that necessitate the creation of an artificial connection between the esophagus and the jejunum. It is important to note that this procedure is performed through an abdominal approach.

5. When to use CPT code 43340

CPT code 43340 should be used when a healthcare provider performs an esophagojejunostomy without a total gastrectomy using an abdominal approach. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 43340, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for an esophagojejunostomy
• Details of the procedure, including the approach (abdominal) and any additional repairs or connections made
• Date of the procedure
• Any complications or additional findings during the procedure
• Details of the closure of the incision
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43340, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the details of the procedure to support the use of this code. Additionally, be aware of any specific billing guidelines or modifiers that may apply to this procedure.

8. Historical information

CPT 43340 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient with esophageal cancer undergoes an esophagojejunostomy without total gastrectomy using an abdominal approach.
2. A patient with a benign esophageal stricture requires an esophagojejunostomy to restore normal gastrointestinal function.
3. An individual with a history of gastric bypass surgery develops complications and requires an esophagojejunostomy to address the issue.
4. A patient with a traumatic injury to the esophagus undergoes an esophagojejunostomy to repair the damage.
5. A person with a congenital abnormality of the esophagus requires an esophagojejunostomy to establish proper gastrointestinal continuity.
6. An individual with severe gastroesophageal reflux disease undergoes an esophagojejunostomy to alleviate symptoms and improve quality of life.
7. A patient with a history of esophageal surgery develops complications and requires an esophagojejunostomy to address the issue.
8. An individual with a recurrent esophageal stricture undergoes an esophagojejunostomy to prevent further narrowing of the esophagus.
9. A person with a history of esophageal cancer recurrence requires an esophagojejunostomy to manage the disease.
10. An individual with a rare congenital anomaly of the esophagus undergoes an esophagojejunostomy to establish normal gastrointestinal function.