CPT® Code 43420

The CPT® Code 43420 refers to the surgical procedure for the closure of an esophagostomy or fistula through a cervical approach. This procedure is specifically indicated when the site of the esophagostomy or fistula is located in the cervical esophagus, which is the portion of the esophagus situated in the neck region. The surgical intervention involves making an incision in the neck, strategically positioned anterior to the sternocleidomastoid muscle. This incision is made between the thyroid gland and the trachea medially, while the carotid sheath is located laterally. During the procedure, critical structures such as the internal jugular vein and carotid artery are identified and carefully retracted laterally to provide adequate access to the esophagus. The closure of the esophagostomy or fistula is essential for restoring normal esophageal function and preventing complications associated with the presence of an abnormal opening in the esophagus. This procedure is distinct from similar procedures that may involve thoracic or abdominal approaches, which are addressed under different CPT® codes. The cervical approach is specifically tailored to address issues arising in the upper segment of the esophagus, ensuring that the surgical technique is appropriate for the anatomical location of the esophagostomy or fistula.