tci General Surgery Coding Alert - 2006 Issue 1

READER QUESTIONS: Redo Nissen Calls for New Nissen Code

Question: The surgeon performed a redo laparoscopic Nissen, but the original surgery was more than 12 years ago. How should I code for this?Colorado Subscriber Answer: The -redo- aspect of the service won't affect your primary coding. You should report the procedure using the standard code for a laparoscopic Nissen procedure--43280 (Laparoscopy, surgical, esophagogastric fundoplasty [e.g., Nissen, Toupet procedures]).Because this procedure is a redo, however, the surgeon may have encountered considerably more difficulty than during a first-time Nissen procedure. For example, the surgeon may encounter excessive scarring or adhesions, or he may have to unwrap and...

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