I need to know how to code a Laparoscopic Nissen fundoplasty with a laparoscopic paraesophageal hernia. I have been told to include the paraesophageal hernia into the 43280 (lap Nissen); what I don't understand is if the paraesophageal repair is far more serious condition why would the repair of this not be the primary procedure instead of being included in the lap Nissen (43280)