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2025 CPT code 43122

Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty.

Adhere to current CPT coding guidelines, including appropriate selection of modifiers if additional procedures are performed.Refer to the official CPT manual for specific guidance.

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.

IMPORTANT:For gastrointestinal reconstruction following a previous esophagectomy, consider codes 43360 and 43361.

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.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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