How To Use CPT Code 43510

CPT 43510 describes a procedure that involves the placement of a permanent intraluminal tube or stent through a narrowed area in the esophagus. This article will provide an overview of CPT code 43510, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 43510?

CPT 43510 is a code used to describe a specific procedure that involves the placement of a permanent intraluminal tube or stent through a narrowed area in the esophagus. This procedure is typically performed for palliative treatment of esophageal stricture, which can result from cancerous overgrowth or scarring due to radiation therapy.

2. Official Description

The official description of CPT code 43510 is: ‘Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin).’ This procedure involves making an incision in the abdomen or stomach, dilating the stricture, and inserting a permanent tube or stent to alleviate the narrowing in the esophagus.

3. Procedure

1. The provider begins by making an incision in the abdomen or, if the abdomen is already open, a small high incision in the stomach.
2. If the stricture has not already been dilated from above during an endoscopic procedure, the provider passes bougies and dilates the stricture from below through the gastrotomy.
3. The provider then attaches the leader of an Atkinson tube to the bougie and draws the tube down until it is positioned inside the stricture.
4. Excess tube is cut off, and the gastrotomy is closed.
5. The provider checks for bleeding, removes any instruments, and closes the incision in the abdomen.

4. Qualifying circumstances

CPT 43510 is typically performed for palliative treatment of esophageal stricture caused by cancerous overgrowth or scarring due to radiation therapy. It is important to carefully review the details of the procedure to ensure accurate coding.

5. When to use CPT code 43510

CPT code 43510 should be used when the provider performs a gastrotomy procedure that involves esophageal dilation and the insertion of a permanent intraluminal tube or stent. This code is specifically for cases where the procedure is performed for palliative treatment of esophageal stricture.

6. Documentation requirements

To support a claim for CPT code 43510, the provider must document the following information:

• Patient’s diagnosis and the need for palliative treatment of esophageal stricture
• Details of the procedure, including the specific tube or stent used
• Date of the procedure
• Incision site and closure method
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 43510, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also be aware of any additional guidelines or modifiers that may be required for accurate billing. It is important to review the documentation and coding guidelines to ensure proper reporting of this procedure.

8. Historical information

CPT code 43510 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for a patient with esophageal stricture caused by cancerous overgrowth.
2. A patient with esophageal stricture due to radiation therapy undergoes a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for palliative treatment.
3. A provider performs a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube to alleviate the narrowing in the esophagus for a patient with advanced cancer.
4. A patient with esophageal stricture resulting from scarring undergoes a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for palliative treatment.
5. A provider performs a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube to improve swallowing function in a patient with esophageal stricture.
6. A patient with esophageal stricture caused by cancerous overgrowth undergoes a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for palliative treatment.
7. A provider performs a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube to alleviate the narrowing in the esophagus for a patient with advanced cancer.
8. A patient with esophageal stricture resulting from scarring undergoes a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for palliative treatment.
9. A provider performs a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube to improve swallowing function in a patient with esophageal stricture.
10. A patient with esophageal stricture caused by cancerous overgrowth undergoes a gastrotomy procedure with esophageal dilation and insertion of a permanent intraluminal tube for palliative treatment.