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An esophagogastric fundoplasty is a surgical procedure aimed at correcting issues related to the esophagus and stomach, particularly in cases of gastroesophageal reflux disease (GERD) or hiatal hernias. This procedure involves the manipulation of the stomach's fundus, which is the uppermost part of the stomach, to create a wrap around the esophagus. The primary goal of this surgery is to enhance the function of the lower esophageal sphincter, thereby preventing the backflow of stomach contents into the esophagus. There are three commonly utilized techniques for performing this procedure: the Nissen fundoplication, the Belsey IV fundoplication, and the Hill gastropexy. Each technique has its specific approach and method of wrapping the stomach around the esophagus, which can vary in the degree of wrap and the surgical approach used (abdominal or thoracic). The Nissen fundoplication involves a complete 360-degree wrap, while the Belsey IV procedure creates a partial 270-degree wrap, and the Hill procedure focuses on anchoring the stomach to the diaphragm to prevent displacement. Understanding these techniques is crucial for medical coders and billers, as they must accurately code the specific procedure performed based on the surgical approach and technique utilized.
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The esophagogastric fundoplasty is indicated for patients experiencing conditions that necessitate surgical intervention to prevent gastroesophageal reflux or to repair hiatal hernias. The following are specific indications for this procedure:
The esophagogastric fundoplasty procedure involves several detailed steps, which vary slightly depending on the specific technique employed. Below are the procedural steps for each technique:
After the esophagogastric fundoplasty, patients typically require monitoring for complications such as infection, bleeding, or difficulty swallowing. Post-operative care may include pain management, dietary modifications, and gradual reintroduction of solid foods. Patients are often advised to avoid heavy lifting and strenuous activities during the initial recovery period. Follow-up appointments are essential to assess healing and ensure the effectiveness of the procedure in alleviating symptoms related to GERD or hiatal hernias.
| Short Descr | REVISE ESOPHAGUS & STOMACH | Medium Descr | ESOPG/GSTR FUNDOPLASTY | Long Descr | Esophagogastric fundoplasty (eg, Nissen, Belsey IV, Hill procedures) | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
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