General Surgery Coding Alert
43314 Depends on Diagnosis
Question: What’s the correct coding for a rigid bronchoscopy, right thoracotomy with division of tracheoesophageal fistula, and repair of esophageal atresia using a thoracic approach?
If the patient suffers from a true congenital esophageal atresia, the best code would be 43314 (Esophagoplasty for congenital defect [plastic repair or reconstruction], thoracic approach; with repair of congenital tracheoesophageal fistula), which covers the fistula repair and the atresia repair.
On the other hand, if the patient suffers from an acquired atresia related to the fistula, the proper code would be 43312 (Esophagoplasty [plastic repair or reconstruction], thoracic approach; with repair of tracheoesophageal fistula).
Your description doesn’t actually indicate that the fistula was repaired — only divided. Presumably the surgeon divided the bridge and repaired each structure, but you should ensure that you have documentation in the op report. If that’s not the case, you might need to select a different code, or possibly code as above but append modifier 52 (Reduced services).
Illinois Subscriber
Answer: The correct answer depends partially on the patient’s condition.
General Surgery Coding Alert
- CCI 19.2:
Greet E/M Bundles for Nearly Every Integumentary Surgery
Focus on three modifiers for unusual cases. If you’re rusty on when evaluation and management [...] - Use modifier 24 when the E/M service meets these criteria
The E/M service occurs during the postoperative period of another procedure The current E/M service [...] - CPT® 2014:
37204 Replaced? Expect Other Vascular Surgery Changes Next Year
Check CPT® editorial panel minutes to glimpse ahead. You don’t have to wait until the [...] - ICD-10:
870-897 Open Wound Options Explode to S00-S99 ICD-10 Categories
Expect more detail for wound type, location. If you thought ICD-9 provided a lot of [...] - Physician Memo:
OIG Recovered $3.8 Billion in Recent 6 Months
Will the agency recoup from you? Make sure you cross your t’s and dot your [...] - You Be the Coder:
List History for Colonoscopy Diagnosis
Question: We had a patient who had a colonoscopy for personal history of colon cancer [...] - Reader Question:
PUNLMP Evades ICD-9
Question: What ICD-9 code should I use for a bladder cancer pathology report diagnosis of [...] - Reader Question:
36556 Sets Termination Requirements
Question: Our surgeon noted that, for a 62-year-old patient, he inserted a central line through [...] - Reader Question:
Completion Colectomy Needs Details
Question: A patient had undergone an earlier extended left hemicolectomy with end colostomy due to [...] - Reader Question:
43314 Depends on Diagnosis
Question: What’s the correct coding for a rigid bronchoscopy, right thoracotomy with division of tracheoesophageal [...]
