A patient diagnosed with achalasia underwent laparoscopic esophagomyotomy (Heller type) and Toupet fundoplication. The provider completed myotomy of the esophagus and stomach. The provider sutured the posterior aspect of the stomach to the cut side of the myotomy on the right side, and sutured the anterior stomach to the cut side of the myotomy on the left side, giving a nice Toupet fundoplication that held open the myotomy site. What is the correct ICD-10-PCS code for laparoscopic esophagomyotomy (Heller type) and Toupet fundoplication to treat achalasia?
The Heller type esophagomyotomy fits the root operation definition of “Division,” which is defined as cutting into a body part without draining fluids and/or gases from the body part in order to separate or transect a body part. “Division” is a more specific depiction than “Dilation” of what was done. Additionally, the Toupet fundoplication is coded using the root operation “Restriction,” because the intent of the fundoplication is to make the lumen of the tubular body part smaller. Assign the following ICD-10-PCS codes:
0D844ZZ Division of esophagogastric junction, percutaneous endoscopic approach, for the myotomy0DV44ZZ Restriction of esophagogastric junction, percutaneous endoscopic approach for the fundoplication