2025 CPT code 39200
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Mediastinum and Diaphragm Surgery Feed
Resection of a mediastinal cyst.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 22 for increased procedural services).
Surgical resection is medically necessary for symptomatic cysts causing compression of surrounding structures (airway, esophagus, vessels) or when there is a suspicion of malignancy.Resection may also be indicated for asymptomatic cysts if there is a risk of complications such as infection, rupture, or malignant transformation. For small, asymptomatic cysts, close monitoring and serial imaging may be preferred over immediate surgical intervention.
The surgeon's responsibilities include patient preparation and positioning, appropriate incision (thoracotomy or sternotomy), exploration of the mediastinum, resection of the cyst, and layered closure of the incision.Pre-operative imaging may be necessary for localization, and post-operative care includes monitoring for complications such as infection or atelectasis.
In simple words: The doctor removes a cyst (a fluid-filled sac) from the middle of the chest (mediastinum).This might involve cutting through the ribs or breastbone to access the cyst, which is then carefully removed. The incision is then closed.
This CPT code encompasses the surgical removal of a cyst located in the mediastinum.Access to the mediastinum is gained through either a thoracotomy (incision into the chest wall) or a median sternotomy (incision through the sternum). The surgeon inspects the mediastinum for any additional pathology and then resects the identified cyst. The surgical approach (thoracotomy or sternotomy) depends on the cyst's location.Post-operative closure involves layered reapproximation of tissues (thoracotomy) or wiring of the sternum and layered closure of soft tissues (sternotomy).
Example 1: A 45-year-old male presents with a mediastinal cyst identified on a routine chest X-ray.The cyst is asymptomatic.Surgical resection is recommended for diagnostic purposes and to prevent potential future complications., A 60-year-old female presents with symptoms of cough and dyspnea.Imaging reveals a large mediastinal cyst causing compression of the airway. Surgical resection is indicated to alleviate symptoms and prevent further airway compromise., A 28-year-old male undergoes a sternotomy for cardiac surgery. An incidental mediastinal cyst is discovered during the procedure.The surgeon elects to resect the cyst while the patient is already under anesthesia.
* Pre-operative imaging (e.g., CT scan, MRI) to confirm the presence and location of the cyst.* Detailed operative report outlining the surgical approach, resection technique, and pathology findings.* Post-operative imaging (optional) to assess for residual cyst or complications.* Pathology report confirming the diagnosis and nature of the cyst.
** The choice of surgical approach (thoracotomy vs. sternotomy) will depend on the location of the cyst and surgeon preference.Complete removal of the cyst wall is recommended to prevent recurrence.Post-operative complications such as atelectasis, pneumonia, and wound infection should be considered.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:Thoracic Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center