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The procedure described by CPT® Code 43285 involves the removal of an esophageal sphincter augmentation device, which is a laparoscopic surgical intervention aimed at treating gastroesophageal reflux disease (GERD). This device, often referred to as a magnetic band, is implanted around the lower esophageal sphincter (LES) to enhance its function. The laparoscopic approach allows for minimal invasiveness, which is beneficial for patient recovery. During the procedure, the gastroesophageal junction (GEJ) is carefully visualized, and the area surrounding the device is meticulously dissected to avoid damage to surrounding structures. The procedure includes the identification and preservation of critical anatomical components such as the mediastinal cavity and the phrenoesophageal ligament, which are essential for maintaining the integrity of the esophagus and diaphragm. The posterior vagus nerve is also located and protected during the operation. The device itself consists of a series of interlinked titanium beads with magnetic cores that work together to keep the LES closed, while allowing it to open during swallowing. The removal process involves careful dissection to free the device from the esophagus, ensuring that the surrounding tissues are not harmed. After the device is successfully extracted, the surgical instruments are withdrawn, and the abdominal cavity is closed using sutures, staples, or Steri Strips, completing the procedure.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 43285 is indicated for patients who have undergone previous implantation of an esophageal sphincter augmentation device and require its removal. This may be due to complications arising from the device, such as device malfunction, discomfort, or adverse effects that necessitate its extraction. Additionally, patients experiencing persistent gastroesophageal reflux symptoms despite the presence of the device may also be candidates for this procedure.
The procedure for the removal of the esophageal sphincter augmentation device begins with the visualization of the gastroesophageal junction (GEJ) using a laparoscope. The surgeon identifies the device and carefully dissects it free from the surrounding esophageal tissue. This step is crucial to prevent any damage to the esophagus during the removal process. Once the device is adequately mobilized, it is extracted from the abdominal cavity. Following the removal, the laparoscope and any additional surgical instruments are withdrawn, and carbon dioxide used during the procedure is released from the abdominal cavity. Finally, the incisions made during the laparoscopic approach are closed using sutures, staples, or Steri Strips, ensuring proper healing and minimizing the risk of infection.
After the removal of the esophageal sphincter augmentation device, patients are typically monitored for any immediate complications. Post-procedure care may include pain management and instructions for activity restrictions to facilitate recovery. Patients are advised to follow up with their healthcare provider to assess healing and address any ongoing symptoms. It is essential to monitor for signs of infection or complications related to the surgical site. Recovery time may vary depending on individual patient factors and the extent of the procedure performed.
| Short Descr | RMVL ESOPHGL SPHNCTR DEV | Medium Descr | REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE | Long Descr | Removal of esophageal sphincter augmentation device | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure |
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| 2017-01-01 | Added | Added |
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