CPT® Code 39220

The procedure described by CPT® Code 39220 involves the surgical resection of a mediastinal tumor. The mediastinum is the central compartment of the thoracic cavity, 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 tissue, in this case, a tumor or cyst located within the mediastinal space. The approach taken by the physician during this procedure is determined by the specific location of the mass within the mediastinum. For tumors located anteriorly, a median sternotomy is commonly performed, which involves making an incision along the sternum to access the chest cavity. Conversely, for posterior lesions, 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 tumor or cyst is identified and exposed. If the lesion is a cyst, the goal is to remove it completely, including the cyst wall, to minimize the risk of recurrence. However, if the cyst wall is firmly attached to critical structures such as the tracheobronchial tree or esophagus, the surgeon may opt to remove only the mucosal lining of the affected area. In cases involving a mediastinal tumor, the objective is to excise the tumor entirely whenever feasible. After the successful removal of the cyst or tumor, the surgical incisions are meticulously closed in layers to promote optimal healing.