Laparoscopic paraesophegeal hernia w/ Nissen

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Dr did a repair of paraesophageal hernia w/ mesh and nissen fundo. In the 2011 March Coders edge it says the nissen codes 43227-43328 include the repair of hiatal hernia.... so it would also include the mesh and we cant bill the 43282 if the mesh is for the hernia? I am so confused!
 

AthensCoder

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Laura,

I am confused on your question; however, I will try and help you to the best of my ability. CPT 43328 is for a esophagogastric fundoplast via a thoroacotomy (this code does NOT include a hernia repair). CPT 43337 would not be the correct code either as this is for a thoracoabdominal approach. According to your post you are looking for "laparoscopic", so the correct code would be 43282., which includes the nissesn, paraesophageal hernia repair and mesh.
 

JJackson506

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Dr did a repair of paraesophageal hernia w/ mesh and nissen fundo. In the 2011 March Coders edge it says the nissen codes 43227-43328 include the repair of hiatal hernia.... so it would also include the mesh and we cant bill the 43282 if the mesh is for the hernia? I am so confused!
43282 would be the correct code to report. Sac dissection and removal, esophageal mobilization, implantation of mesh and so on are inherent in a laparoscopic repair of a paraesophageal hernia.

See this article from the American College of Surgeons...http://www.facs.org/fellows_info/bulletin/2011/socioeconomic0911.pdf
 
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Thanks for the help! We were in a discussion about the mesh...it was thought that the mesh was included in the hernia repair and could only be coded if it wasn't used for the hernia only? But I will use the article for my defense :)
 
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