CPT® Code 39200

The procedure described by CPT® Code 39200 involves the surgical resection of a mediastinal cyst, which is a fluid-filled sac located in the mediastinum, the central compartment of the thoracic cavity. This area is situated between the lungs and contains vital structures such as the heart, trachea, esophagus, and major blood vessels. The term "resection" refers to the surgical removal of the cyst, which may be necessary due to symptoms caused by the cyst or concerns regarding its nature. The approach taken by the physician during this procedure is determined by the specific location of the cyst within the mediastinum. For cysts located in the anterior mediastinum, a median sternotomy is typically performed, which involves making an incision along the sternum to gain access to the chest cavity. Conversely, for cysts situated in the posterior mediastinum, a posterolateral approach is utilized, allowing access from the side of the chest. During the procedure, the surgeon carefully dissects through the surrounding tissues to reach the mediastinal space, where the cyst or tumor is identified and exposed. If the lesion is confirmed to be cystic, the goal is to remove it completely, including the cyst wall, to minimize the risk of recurrence. However, if the cyst wall is found to be adherent to critical structures such as the tracheobronchial tree or esophagus, complete resection may not be feasible, and the surgeon will instead remove the mucosal lining of the affected area. In cases where a mediastinal tumor is present, the objective is to excise the tumor entirely whenever possible. After the successful removal of the cyst or tumor, the surgical incisions are meticulously closed in layers to promote proper healing.