December 2014 page 16a
Surgery: Digestive System
Question: What is the appropriate code to report for hiatal hernia "repair" (eg, figure of eight suture) at the time of bariatric surgery?
Answer: Currently, there is no CPT code to describe repair of the hiatus in conjunction with any of the bariatric procedures. Therefore, the unlisted laparoscopy procedure code for the repair of the hiatus, code 43289, Unlisted laparoscopy procedure, esophagus, should be reported.
When reporting an unlisted code to describe a procedure or service, it is necessary to submit supporting documentation (eg, procedure report) along with the claim to provide...
Note: The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.
Article Overview
This December 2014 CPT Assistant Q&A reviews coding questions in digestive system surgery. It discusses how to approach certain laparoscopic hernia-related scenarios, when unlisted procedure codes are considered, and the importance of supporting documentation. The article is useful for coders, billers, and compliance staff working with bariatric and hernia cases.
Why This Topic Matters
Digestive system surgery coding can involve procedures that do not map neatly to a single listed CPT code. Understanding the article helps readers recognize when unlisted procedures are discussed and why documentation matters for claim submission.
Article Sections
Hiatal hernia repair at the time of bariatric surgery
Addresses a coding question involving hiatus repair in the setting of bariatric surgery and discusses the broader issue of reporting an unlisted laparoscopic procedure code.
Morgagni hernia with laparoscopic repair and mesh
Reviews a separate laparoscopic hernia scenario involving mesh and compares it with related hiatal hernia coding references and unlisted procedure reporting.
What You Will Learn
The scope of digestive system surgery coding questions covered in this Q&A
How the article frames unlisted procedure reporting in laparoscopic scenarios
Why certain hernia-related cases are discussed separately from related hiatal hernia references
What general documentation considerations are highlighted for unlisted claims
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