2025 CPT code 43287
(Active) Effective Date: N/A Revision Date: N/A Surgery - Laparoscopic Procedures on the Esophagus Surgical Procedures on the Esophagus Feed
Laparoscopic distal two-thirds esophagectomy with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy; with thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic esophagogastrostomy (Ivor Lewis esophagectomy).
Modifiers may be applicable depending on the circumstances of the surgery. Examples include modifiers for multiple procedures (51), reduced services (52), or assistant surgeon (80).
Medical necessity is established by the presence of esophageal cancer, severe esophageal injury requiring resection, or spontaneous esophageal rupture.Appropriate documentation supporting the diagnosis and demonstrating the need for surgical intervention is required for reimbursement.
The clinical responsibility includes the complete surgical procedure, encompassing preoperative assessment, informed consent, intraoperative management, and postoperative care.This includes laparoscopic and thoracoscopic mobilization of the esophagus, gastrectomy, pyloric drainage (if performed), esophagogastrostomy, and postoperative monitoring for complications.
In simple words: This surgery removes the lower two-thirds of the esophagus and part of the stomach using small incisions in the abdomen and chest.The surgeon uses a camera and special instruments to reconnect the remaining parts of the esophagus and stomach. This is often done to treat esophageal cancer or severe damage to the esophagus.
This CPT code describes a laparoscopic thoracoscopic esophagectomy, also known as an Ivor Lewis esophagectomy.The procedure involves the removal of the distal two-thirds of the esophagus and a portion of the proximal stomach.This is achieved through a combined laparoscopic and thoracoscopic approach. Laparoscopically, the surgeon mobilizes the abdominal and lower mediastinal portions of the esophagus, performs a proximal gastrectomy, and may perform a pyloric drainage procedure. Thoracoscopically, the surgeon mobilizes the middle and upper mediastinal esophagus, and then performs an esophagogastrostomy (reconnection of the esophagus and stomach).The procedure is typically indicated for esophageal cancer, severe esophageal damage from caustic ingestion, or repair of spontaneous esophageal rupture.
Example 1: A 60-year-old male patient presents with a diagnosis of esophageal cancer involving the distal two-thirds of the esophagus.A laparoscopic thoracoscopic esophagectomy (43287) is performed to resect the cancerous tissue, followed by an esophagogastrostomy.Pyloric drainage is also performed during the laparoscopic stage., A 45-year-old female patient sustained a severe esophageal burn from caustic ingestion. The damaged portion of the esophagus is extensive, necessitating resection. A 43287 procedure is indicated to remove the damaged tissue and restore esophageal continuity via esophagogastrostomy., A 72-year-old male patient experiences a spontaneous esophageal rupture.Surgical repair is necessary to prevent further complications. The surgeon chooses a laparoscopic thoracoscopic approach (43287) for resection and reconstruction of the injured area.
Preoperative imaging (CT scan, endoscopy), pathology reports confirming malignancy or extent of damage, operative report detailing the procedure steps, and postoperative recovery notes.Complete anesthesia records and any complications encountered during or after the surgery should also be documented.
** The description of this procedure is very detailed and thorough.It is crucial to correctly document the exact steps taken during the procedure, which will help ensure proper coding.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided text.RVUs vary based on geographic location and other factors.
- Global Days: The global period for this procedure would typically be 90 days, encompassing the preoperative, intraoperative, and postoperative care.The exact global period may vary depending on payer guidelines and specific circumstances.
- Payment Status: Active
- Modifier TC rule: This code does not typically involve separate professional and technical components, so a TC modifier would not usually be applied. However, the application of modifiers should always be based on the specific circumstances of the case and in compliance with payer guidelines.
- Fee Schedule: Fee schedule information is not available in the provided text. It is recommended to refer to the most recent fee schedule from the appropriate payer or a reputable medical billing resource.
- Specialties:Thoracic Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center