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Laparoscopic paraesophegeal hernia w/ Nissen

  1. #1
    Default 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!

  2. Default
    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.
    Sonja Little, CPC

  3. #3
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    Quote Originally Posted by laura_clffrd@yahoo.com View Post
    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/bul...onomic0911.pdf

  4. #4
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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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