AHA Coding Clinic® for HCPCS - 2019 Issue 2; Ask the editor

Linx device

Previous Coding Clinic for HCPCS advice published in Third Quarter 2018 states to report CPT code 43284, Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed, for the LINX implantation procedure performed with the hiatal hernia repair. In addition, we are aware that CPT guidance and National Correct Coding Initiative (NCCI) edits prevent the reporting of CPT code 43281, Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh, with CPT code 43284. However, CPT code 43284 is a column 2 code indicating CPT code 43281 is the primary procedure. If both codes cannot be reported together, what is the correct code assignment for both repair of a hiatal hernia and a LINX procedure? If the hiatal hernia is an incidental finding does that affect code assignment? ...

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