2025 CPT code 43122
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty.
Modifiers may be applicable depending on the specific circumstances of the surgery.Consult the CPT manual for more specific details on modifier use.
Medical necessity is established by the presence of a condition that necessitates the surgical procedure, such as esophageal cancer, severe esophageal injury from caustic ingestion, or a spontaneous esophageal rupture that requires surgical intervention for repair and restoration of esophageal function.
The surgeon is responsible for all aspects of the procedure, from pre-operative planning and patient preparation to the surgical resection, reconstruction, and post-operative care.This may involve collaboration with anesthesiologists, nurses, and other medical professionals. Specific responsibilities will vary by surgical setting.
In simple words: The surgeon removes part of the esophagus and may also remove a part of the upper stomach.The remaining parts are then reconnected.The surgeon might also widen the opening where the stomach connects to the intestines to help food move through easily.
This procedure involves the partial removal of the esophagus, possibly including a portion of the proximal stomach, through a thoracoabdominal or abdominal incision.The remaining esophagus is then reconnected to the stomach (esophagogastrostomy).A pyloroplasty (widening of the pyloric valve) may also be performed to improve gastric emptying.This surgery is indicated for conditions such as esophageal cancer, caustic ingestion injuries, or spontaneous esophageal rupture.
Example 1: A 65-year-old male presents with esophageal cancer.A partial esophagectomy with esophagogastrostomy and pyloroplasty is performed via a thoracoabdominal approach., A 40-year-old female sustains a spontaneous esophageal rupture.A partial esophagectomy with esophagogastrostomy is performed via an abdominal approach., A 50-year-old male has severe esophageal damage from caustic ingestion.A partial esophagectomy, with removal of a portion of the proximal stomach, esophagogastrostomy, and pyloroplasty is undertaken via a combined thoracoabdominal and abdominal approach.
* Pre-operative evaluation including imaging studies (e.g., endoscopy, CT scan) to assess the extent of the disease.* Operative report detailing the extent of resection, type of anastomosis, and any additional procedures performed.* Pathology report confirming the diagnosis and assessing the margins of resection.* Post-operative recovery notes and any complications encountered.
** This code encompasses a range of procedures with varying complexity.Accurate coding requires detailed documentation of the surgical approach, extent of resection, and any additional procedures performed.Consult with a qualified medical coding specialist if unsure.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided text.Refer to the CMS national physician fee schedule or other relevant payer resources for RVU data.
- Global Days: The global period for this procedure varies depending on payer and specific circumstances.Consult payer guidelines for definitive information.
- Payment Status: Active
- Modifier TC rule: The applicability of a Technical Component (TC) modifier depends on the context and might not apply to this code. Consult with billing and coding resources for current interpretations.
- Fee Schedule: Fee schedule data is not provided in the source. This information is payer-specific and changes frequently.Refer to your payer’s fee schedule for the most accurate and up-to-date information.
- Specialties:General Surgery, Thoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center