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Esophagogastric fundoplasty, specifically the Thal-Nissen procedure, is a surgical intervention designed to address complications arising from a hiatal hernia and gastroesophageal reflux disease (GERD). This procedure aims to restore the normal anatomical position of the stomach and esophagus, thereby alleviating symptoms associated with reflux. The term "fundoplasty" refers to the surgical technique that involves the manipulation of the fundus, which is the upper part of the stomach, to create a barrier against the backflow of gastric contents into the esophagus. The procedure is performed using a transpleural approach, which involves accessing the esophagus through the pleural cavity, allowing for better visualization and mobilization of the esophagus and surrounding structures. The surgical steps include making incisions in the diaphragm and stomach, mobilizing the greater curvature of the stomach, and utilizing a split thickness skin graft to reinforce the fundus. The ultimate goal of the Thal-Nissen procedure is to create a functional valve mechanism at the esophagogastric junction, thereby reducing the incidence of reflux and improving the patient's quality of life.
© Copyright 2025 Coding Ahead. All rights reserved.
The Thal-Nissen procedure is indicated for patients suffering from conditions that necessitate surgical intervention to correct anatomical and functional abnormalities of the esophagus and stomach. The following are the primary indications for this procedure:
The Thal-Nissen procedure involves several critical steps to effectively perform the fundoplasty. Each step is designed to ensure proper alignment and function of the esophagus and stomach.
After the Thal-Nissen procedure, patients typically require monitoring for any complications related to the surgery. Post-procedure care may include pain management, monitoring for signs of infection, and ensuring proper function of the esophagogastric junction. Patients may also need to follow specific dietary guidelines during the recovery period to facilitate healing and prevent complications. The expected recovery time can vary, but patients are generally advised to avoid strenuous activities for a period to allow for proper healing of the surgical site.
| Short Descr | REVISE ESOPHAGUS & STOMACH | Medium Descr | ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH | Long Descr | Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
| 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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). |
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| 2016-01-01 | Changed | Code description changed. |
| 2012-01-01 | Changed | Code description changed. |
| 2011-01-01 | Changed | Long description changed. |
| Pre-1990 | Added | Code added. |
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