2025 CPT code 43135
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach.
Modifiers may be applicable depending on the circumstances. Refer to current CPT guidelines for modifier usage.
Medical necessity should be established by documenting the patient’s symptoms, the failure of conservative treatment options, and the impact of the diverticulum on the patient’s quality of life. The documentation should support the need for surgical intervention.
The surgeon performs the procedure after the patient is prepped and anesthetized. This includes making the incision, inspecting the area, removing the diverticulum, repairing the hypopharynx or esophagus, irrigating the site, and closing the wound.
In simple words: This procedure involves removing a pouch from the lower part of your throat or food pipe through an incision in your chest. The surgeon may also cut a muscle in the area. The area is then repaired, and the incision is closed.
This code describes a surgical procedure where the provider removes a diverticulum (an abnormal pouch) from the hypopharynx (lower part of the pharynx) or esophagus through a thoracotomy (incision in the chest). The procedure may also include a myotomy (cutting of a muscle) if necessary.The diverticulum is grasped and removed, often by oversewing or excision. The hypopharynx or esophagus is then repaired, and the surgical site is closed.
Example 1: A patient presents with dysphagia (difficulty swallowing) and regurgitation due to a large diverticulum in the esophagus. The diverticulum is causing food to become trapped, leading to infections and discomfort. The thoracic approach is chosen due to the size and location of the diverticulum. , A patient with a Zenker's diverticulum (a specific type of diverticulum in the hypopharynx) has persistent symptoms despite conservative management. Surgical removal via a thoracic approach is deemed necessary due to the complexity of the diverticulum., A patient has a diverticulum that has perforated, leading to mediastinitis (inflammation of the chest cavity). The thoracic approach is necessary to address both the diverticulum and the resulting infection in the chest cavity.
Documentation should include the location and size of the diverticulum, the surgical approach used (thoracic), any associated procedures performed (e.g., myotomy), and any complications encountered. Preoperative imaging and endoscopic findings should also be documented.
- Revenue Code: P1G - Major Procedure - Other
- Specialties:Thoracic Surgery, Otolaryngology (ENT), General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center