2025 CPT code 43116
(Active) Effective Date: N/A Revision Date: N/A Surgery - Esophagus Surgical Procedures on the Digestive System Feed
Partial esophagectomy in the neck with a free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction.
Modifiers 52 (reduced services) and potentially others may be applied depending on the circumstances of the procedure.Consult the AMA CPT codebook for detailed modifier usage guidelines.
Medical necessity is established by the presence of a clinically significant esophageal condition requiring resection and reconstruction. This could include malignant neoplasms, benign strictures, trauma, or other conditions compromising esophageal function.Justification should be documented in the medical record.
The surgeon is responsible for all aspects of the procedure, including pre-operative assessment, incision, identification and removal of diseased esophageal tissue, harvesting of the intestinal graft, anastomosis of the intestinal ends, microvascular anastomosis of the graft to the esophagus, leak testing, and wound closure.This requires significant surgical expertise in both esophageal and gastrointestinal surgery.
In simple words: The doctor removes a diseased part of the esophagus in the neck and replaces it with a piece of intestine from the abdomen.Tiny blood vessels are connected using a microscope to ensure the new intestine receives blood flow.
This procedure involves the surgical removal of a diseased portion of the esophagus in the neck.A segment of intestine (colon or small bowel) is harvested as a graft, its ends are anastomosed to maintain bowel continuity, and it's then meticulously connected to the remaining cervical esophagus using microsurgical techniques and microvascular anastomosis (connecting small esophageal arteries and veins to the graft under a surgical microscope).Leak testing might be performed using air or dye.The incisions are closed in layers.
Example 1: A patient presents with esophageal cancer involving the cervical esophagus.A partial esophagectomy with a colon interposition graft is performed using 43116., A patient has a stricture of the cervical esophagus due to ingestion of a corrosive substance.A partial esophagectomy and jejunal interposition is performed using 43116., A patient suffers a spontaneous rupture of the cervical esophagus. A partial esophagectomy and colonic interposition is necessary, coded 43116.
Detailed operative notes including the extent of resection, type of graft used, description of microvascular anastomosis, leak testing results, and pathology report.Preoperative imaging (e.g., CT scan, endoscopy), intraoperative photographs or videos, and postoperative recovery notes are essential.
** This procedure requires specialized surgical skills and equipment.The complexity and time involved may vary depending on the patient's specific condition and the extent of the resection and reconstruction.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in provided sources.Consult the CMS national fee schedule for current RVU values.
- Global Days: Information not available in provided sources.The global period varies depending on payer and specific circumstances. Consult payer guidelines.
- Payment Status: Active
- Modifier TC rule: Information not provided in the source.
- Fee Schedule: Information not available in provided sources.Consult historical CMS fee schedules or other relevant fee databases.
- Specialties:Thoracic Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center