Need Help/Opinions Please


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I need help coding the followign OP report. So far I have the following codes: 43332, 43840, 49440, but I don't have a code for the gastropexy. I am thinking 43999.

Preop/post op Dx: Hiatal hernia with gastric outlet obstruction

Procedures Performed:
1. Exploratory Laparotomy with reduction of incarcerated hiatal hernia.
2. Sutured Gastropexy
3. GAstrostomy tube placement

A midline incision was made, was carried through the underlying midline fascia. Entry into the abdominal cavity was obtained. The stomach was found to be for the most part present within the chest. There was approx. 3cm of distal stomach present within the abdomen. This was tediously reduced back within the abdominal cavity. There was one area of serosal tear with gastrorrhaphy performed. This was performed with 3-0 silk in an interrupted fashion. A site was chosen on the anterior gastric wall and the stomach was secured to the anterior gastric wall in the left upper quadrant using 3-0 silk in an interrupted fashion. Two concentric purestrings were placed of 2-0 Vicryl. A gastrotomy was performed. A Moss gastrostomy tube was advaced through the abdominal wall and advanced into the gastric lumen and the tip was placed into the duodenum, with some difficulty. The pylorus itself was widely patent, but hust the anglwe of the tube made it somewhat difficult to place it into the duodenum. It was placed past the pylorus and remained within the second portion of the duodenum.

Any help/opinions would be appreciated.