Treating GERD and hiatal hernias with minimally invasive surgeryNissen fundoplication is a surgical procedure used to treat gastroesophageal reflux disease, or GERD, and hiatal hernia. It tightens and reinforces the sphincter at the top of the stomach to prevent stomach acid from rising into the esophagus. Show
A hiatal hernia (paraesophageal/diaphragmatic hernia) is when part of the stomach extends up through the diaphragm and into the chest. This condition can cause severe acid reflux or GERD symptoms. Often, these symptoms can be treated with medications, but if those don’t work, your doctor may offer surgery as an option. Nissen fundoplications and paraesophageal hernia repairs are often done together. Hiatal hernia surgery corrects the hernia by pulling the stomach back into the abdomen and making the opening in the diaphragm smaller, while the fundoplication tightens the lower esophageal sphincter. Our surgeons use minimally invasive techniques, including robotics, to perform the procedure. The type of method chosen will vary according to the particular health condition. Do you need a Nissen fundoplication/paraesophageal hernia repair?To determine whether you need this procedure, your doctor might perform a variety of diagnostic tests and procedures including:
How to prepare for fundoplication/paraesophageal hernia repair surgeryPrior to the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Talk to your doctor about:
Checklist of things to do before surgery
What to expect during a Nissen fundoplication procedure/paraesophageal repairThe surgery will typically take between 2 to 3 hours to complete. It is typically performed in the cardiothoracic operating room. Check with your doctor about the details of your procedure. In general:
What to expect after fundoplication/paraesophageal hernia repairAfter the surgery, patients usually stay in the hospital for 1 to 2 days. In general:
AHA Coding Clinic® for HCPCS - 2017 Issue 2; Ask the EditorA patient with a history of a hiatal hernia repair and Nissen fundoplication in 2013 was seen at our facility and found to have a recurrent hiatal hernia with dysphagia and reflux, twisting of the distal esophagus and an extremely loose fundoplication. In order to get good visualization of the hiatus as well as to get a better fundoplication, the previous fundoplication had to be taken down. A GIA stapler was inserted and fired across the previous fundoplication as close to the suture line as possible. Once the crural stitch had been placed, a 10 x 10 sheet of biologic mesh was placed. Fundoplication was then performed using 0 Silk and Ti-Knot. The plication appeared loose and the clamp passed through it easily. Posterior wrap was then secured to the crura with a single stitch. Our Encoder directs us to Unlisted CPT code 43289 for a revision and/or takedown. Some of our coders agree with this because the procedure involves more than the description of 43282. Others feel 43282 is appropriate. What is the CPT code(s) to use for a Laparoscopic Re-do hiatal hernia repair with patch reinforcement and Fundoplication? ... To read the full article, sign in and subscribe to the AHA Coding Clinic® for HCPCS. Thank you for choosing Find-A-Code, please Sign In to remove ads. What is the CPT code for laparoscopic hiatal hernia repair?CPT codes 43280 (laparoscopic), 43325, 43327, 43328 (open) are the correct codes to report for an esophagogastric fundoplasty. Per CPT and NCCI, the esophagogastric fundoplasty includes any associated type I hiatal hernia repair; which is not reported separately.
Is hiatal hernia repair the same as fundoplication?Hiatal hernia surgery corrects the hernia by pulling the stomach back into the abdomen and making the opening in the diaphragm smaller, while the fundoplication tightens the lower esophageal sphincter. Our surgeons use minimally invasive techniques, including robotics, to perform the procedure.
What is the difference between CPT code 43280 and 43281?CPT 43281 is separately payable when performed with a bariatric procedure, CPT 43280 is not. The difference between the two codes is that in 43281 the hernia sac is removed and then the area is repaired; in 43280 the hernia is only repaired via sutures.
What is laparoscopic hiatal hernia repair with Nissen Fundoplication?During the Nissen fundoplication, the upper part of the stomach is wrapped around the LES to strengthen the sphincter, prevent acid reflux, and repair a hiatal hernia. The Nissen fundoplication is usually performed as a laparoscopic (minimally invasive) procedure.
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