CPT for ENT: Zenker's Diverticulum

CPT for ENT: Zenker's Diverticulum

Zenker’s Diverticulum is a pouch found above the cervical esophagus. It causes swallowing difficulties (Dysphagia), regurgitation, weight loss and other symptoms. When an Otolaryngologist performs open surgical excision of a Zenker’s diverticulum, he or she should report CPT code:

  • 43130 - Diverticulectomy of the hypopharynx or esophagus, with or without myotomy; cervical approach

However, with recent advances in technology, most otolaryngologists choose to perform these excisions endoscopically. Currently, there are not any codes for the endoscopic removal of Zenker’s diverticulum. In order to code properly for endoscopic removal of a Zenker’s diverticulum, the Academy recommends use of the unlisted procedure code(s):

  • •43499 - Unlisted procedure, esophagus

Do not select a CPT code that only approximates the service provided. If you are unable to find an exact description of the procedure as performed, you should report the most appropriate unlisted procedure code.

Reviewed April 2008
Reviewed July 2006

Important Disclaimer Notice (Updated 8/7/14)

CPT for ENT articles are a collaborative effort between the Academy’s team of CPT Advisors, members of the Physician Payment Policy (3P) workgroup, and health policy staff. Articles are developed to address common coding questions received by the health policy team, as well as to clarify coding changes and correct coding principles for frequently reported ENT procedures. These articles are not intended as legal, medical, or business advice and are not a guarantee of reimbursement. The information is also not meant to serve as the definitive or sole authority on billing and coding issues. The applicability of AAO-HNS billing and coding guidance for a particular procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. You should consult with your own advisors as well as Medicare or private carriers in making any decisions about how to bill and code particular services or procedures.