Wiki Robotic repair of paraesophageal hernia


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Hi: I sure hope someone can assist me with this

The surgeon did an Robotic assisted repair of paraesophageal hernia w/ mesh.

Pt was placed in reverse trendelenburg position. Abdominal wall was prepared. Six small incisions were taken, after inflating the peritoneal cavity with CO2 and robotic arms are docked.

The liver was retraced and the hernia was reduced and the hernial sac was dissected and divided. Gore-Tex mesh was placed...etc etc.

I am not sure what to use for the procedure..S9200 identifies this was done as robotic but not sure if I should code as via Laparotomy (43333) or thoracoabdominal (43337) Or maybe neither of these are correct !

Also is there any know coding guidelines for instances like this... I can not locate any..

Any assistance would be greatly appreciated!

Thank you!!
this isn't my area of expertise, but what about 43282: Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh

The physician repairs a paraesophageal hernia using a laparoscope and may also perform a fundoplasty when indicated. With the patient under anesthesia and in a supine position, the physician places laparoscopic ports in the upper abdomen, through which the appropriate surgical instruments are inserted. With the left lateral segment of the liver retracted, the hiatus is exposed. The physician reduces the herniated stomach into the abdomen and dissects the hernia sac and gastroesophageal fat pad using a combination of sharp and blunt dissection. If a fundoplasty is indicated, the physician identifies the fundus and the esophagus and resects them. The fundus is wrapped around the lower end of the esophagus, which is rejoined to the stomach with sutures. The instruments and trocars are removed and the incisions are closed with sutures. Report 43281 for a procedure performed without the implantation of mesh and 43282 for one requiring mesh implantation.
My surgeons do several types of robotic procedures and we use the laparoscopic codes for those procedures. They really are just lap. procedures done with the assist of the robot.