AHA Coding Clinic® for HCPCS - 2017 Issue 4; Ask the Editor

Transoral endoscopic Zenker’s diverticulostomy

A patient with dysphagia and a Zenker’s diverticulum was scheduled to undergo a transoral endoscopic Zenker’s diverticulostomy. According to the operative report, utilizing the CO2 laser, the party wall was divided, completely cutting through the cricopharyngeus muscle. This eliminated the Zenker’s pouch and allowed for communication with the esophagus anteriorly. What is the appropriate CPT code for a transoral endoscopic Zenker’s diverticulostomy with CO2 laser? CPT code 43180, Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (Zenker’s diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed, seems close, but this does not mention use of CO2 laser or other method to treat Zenker’s diverticulum. ...

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