2025 CPT code 43118
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small bowel reconstruction, including bowel mobilization, preparation, and anastomosis(es).
Modifiers such as -22 (Increased Procedural Services), -51 (Multiple Procedures), etc., may be applicable depending on the specific circumstances of the procedure and any additional services provided.
Medical necessity for 43118 is established by the presence of a condition affecting the distal esophagus requiring surgical resection, such as cancer, severe stricture, or traumatic injury. The medical record should clearly document the severity of the condition and the rationale for esophagectomy with reconstruction.
In simple words: The surgeon removes the lower two-thirds of the esophagus through incisions in the chest and abdomen. Part of the stomach might also be removed. The esophagus is then replaced with a section of the colon or small intestine.
The provider performs a partial esophagectomy of the distal two-thirds of the esophagus, utilizing a thoracotomy and a separate abdominal incision. This may involve a proximal gastrectomy. The esophagus is reconstructed using either a colon interposition or a small bowel segment, and the procedure includes bowel mobilization, preparation, and the necessary anastomoses.
Example 1: A patient presents with esophageal cancer located in the distal two-thirds of the esophagus. The surgeon performs a partial esophagectomy (43118) to remove the cancerous portion, reconstructing the esophagus using a segment of the colon., A patient has severe damage to their lower esophagus due to ingestion of a corrosive substance. The surgeon performs 43118 to remove the damaged section, and reconstructs the alimentary tract using a portion of the small bowel., A patient experiences a spontaneous rupture of the distal esophagus. The surgeon performs code 43118 to resect the ruptured segment, opting for a colon interposition to restore esophageal continuity.
Operative report detailing the extent of the esophagectomy, method of reconstruction, and any concurrent procedures. Pathology report confirming the diagnosis and margins of resection. Preoperative imaging studies (e.g., CT, barium swallow) documenting the esophageal lesion.
- Specialties:Thoracic Surgery, General Surgery
- Place of Service:Inpatient Hospital