How To Use CPT Code 43352

CPT 43352 describes the surgical procedure known as esophagostomy, specifically the fistulization of the esophagus through a cervical approach. This article will provide an overview of CPT code 43352, 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 43352?

CPT 43352 is a code used to describe a surgical procedure called esophagostomy, which involves creating a connection between the esophagus and the outside of the body. This connection allows for drainage and is performed through a cervical approach, meaning the surgeon accesses the esophagus through an incision in the neck.

2. Official Description

The official description of CPT code 43352 is: ‘Esophagostomy, fistulization of esophagus, external; cervical approach.’

3. Procedure

1. The surgeon begins by making an incision in the neck to access the esophagus or the esophageal stump.
2. They then either incise the esophagus or prepare the end of the esophagus stump for connection to the fistula.
3. An incision is made at the external site chosen for the fistula.
4. The surgeon then fastens the esophageal opening to the external opening, creating the connection.
5. This opening allows for the attachment of an appropriate appliance to drain the esophagus.
6. Finally, the surgeon closes the neck incision in layers.

4. Qualifying circumstances

CPT 43352 is used when a surgical connection is created between the esophagus and the outside of the body through a cervical approach. This procedure is typically performed on patients who require drainage from the esophagus due to certain conditions or complications. It is important to note that this code specifically applies to the cervical approach; if the surgeon uses a chest incision instead, a different code should be used.

5. When to use CPT code 43352

CPT code 43352 should be used when a surgeon performs the esophagostomy procedure through a cervical approach. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the surgeon uses a different approach, a different code should be used to accurately reflect the procedure performed.

6. Documentation requirements

When documenting a claim for CPT code 43352, the following information should be included:

• Patient’s diagnosis or condition necessitating the esophagostomy procedure
• Details of the surgical approach, specifically the cervical approach
• Date of the procedure
• Specific steps taken during the procedure, including the incisions made and the connection created
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT code 43352, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The surgeon must have performed the procedure through a cervical approach, as described in the official description. It is also important to follow any additional guidelines or requirements set forth by the payer or insurance company. Additionally, it is important to note that CPT code 43352 should not be reported with other codes unless specific circumstances warrant it.

8. Historical information

CPT code 43352 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates or changes since its addition.

9. Examples

1. A surgeon performs an esophagostomy procedure through a cervical approach to create a connection between the esophagus and the outside of the body for a patient with esophageal cancer.
2. Using a cervical approach, a surgeon performs an esophagostomy procedure to provide drainage for a patient with a severe esophageal stricture.
3. A patient with a recurrent esophageal fistula undergoes an esophagostomy procedure through a cervical approach to establish an external opening for drainage.
4. For a patient with a complex esophageal injury, a surgeon performs an esophagostomy procedure through a cervical approach to facilitate healing and prevent further complications.
5. Using a cervical approach, a surgeon performs an esophagostomy procedure to provide long-term drainage for a patient with a chronic esophageal abscess.
6. A patient with a recurrent esophageal leak undergoes an esophagostomy procedure through a cervical approach to establish an external opening for continuous drainage.
7. For a patient with a severe esophageal obstruction, a surgeon performs an esophagostomy procedure through a cervical approach to provide immediate relief and facilitate further treatment.
8. Using a cervical approach, a surgeon performs an esophagostomy procedure to establish an external opening for drainage in a patient with a complicated esophageal diverticulum.
9. A patient with a recurrent esophageal stricture undergoes an esophagostomy procedure through a cervical approach to provide long-term relief and prevent further complications.
10. For a patient with a complex esophageal fistula, a surgeon performs an esophagostomy procedure through a cervical approach to establish an external opening for continuous drainage and promote healing.