2025 CPT code 43030
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Cricopharyngeal myotomy is a surgical procedure to incise the cricopharyngeal muscle, relieving swallowing difficulties.
Modifiers may be applicable based on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural services, 22 for increased procedural services, etc.)
Medical necessity for cricopharyngeal myotomy is established by the presence of significant dysphagia refractory to conservative management (e.g., dietary modifications, speech therapy). The diagnosis must be confirmed through appropriate imaging and/or physiological studies, demonstrating impaired relaxation of the cricopharyngeal muscle.The procedure should be considered only when the potential benefits outweigh the risks.
The surgeon performs the cricopharyngeal myotomy, which involves prepping the patient, making incisions in the neck to expose the UES, performing the myotomy (muscle incision), and closing the incisions.
In simple words: This surgery helps people who have trouble swallowing. The surgeon makes a small cut in a muscle in the throat that controls swallowing. This makes it easier to swallow food and liquids.
Cricopharyngeal myotomy is a surgical procedure performed to alleviate dysphagia (difficulty swallowing) caused by cricopharyngeal spasm or achalasia.The procedure involves a surgical incision of the cricopharyngeal muscle, a part of the upper esophageal sphincter (UES). This incision reduces the muscle's ability to contract, improving the passage of food and liquids through the esophagus. The approach can be either through a small neck incision (external approach) or via an endoscope inserted through the mouth (endoscopic approach).The surgical technique includes exposing the UES, creating a precise incision in the muscle, and then closing the incision in the soft tissue and skin.
Example 1: A 60-year-old patient presents with persistent dysphagia due to cricopharyngeal spasm, confirmed by videofluoroscopic swallowing study (VFSS).The surgeon performs an external cricopharyngeal myotomy via a small cervical incision., A 45-year-old patient experiences intermittent dysphagia and is diagnosed with cricopharyngeal achalasia.The physician opts for an endoscopic cricopharyngeal myotomy using a laser to precisely incise the muscle., A 72-year-old patient with Zenker's diverticulum undergoes a cricopharyngeal myotomy in conjunction with diverticulectomy to address both swallowing difficulties and the diverticulum itself.
* Detailed history and physical examination documenting the patient's swallowing difficulties.* Diagnostic imaging studies (e.g., VFSS, barium swallow, endoscopy) confirming the diagnosis of cricopharyngeal spasm or achalasia.* Operative report detailing the surgical technique, approach (external or endoscopic), and any complications.* Pathology report if any tissue is removed.* Postoperative progress notes documenting the patient's recovery and improvement in swallowing function.
** The choice between an endoscopic or open approach depends on factors such as patient anatomy, the severity of the condition, and surgeon preference.Complications may include bleeding, infection, injury to surrounding structures, and recurrent dysphagia.
- Revenue Code: P1G - MAJOR PROCEDURE - OTHER
- Payment Status: Active
- Specialties:Otolaryngology, Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center