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Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum, refers to a minimally invasive surgical procedure aimed at addressing issues related to previously implanted gastric neurostimulator electrodes. This procedure is specifically indicated for patients who have undergone prior implantation of these electrodes, which are used to treat medically refractory gastroparesis, a condition characterized by delayed gastric emptying that can lead to severe symptoms such as nausea, vomiting, and abdominal discomfort. The gastric neurostimulator, often referred to as a gastric pacemaker, functions by delivering continuous high-frequency, low-energy electrical stimulation to the nerves of the lower stomach, promoting contractions that facilitate gastric emptying. The revision or removal of these electrodes may be necessary due to complications, device malfunction, or the need for repositioning. It is important to note that this code is distinct from the initial implantation or replacement of the electrodes, which is designated by CPT® Code 43647. The laparoscopic approach allows for reduced recovery time and minimal scarring compared to traditional open surgery, making it a preferred method for such interventions.
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The procedure for laparoscopic revision or removal of gastric neurostimulator electrodes is indicated for patients experiencing complications or issues related to previously implanted electrodes. The following conditions may warrant this surgical intervention:
The laparoscopic procedure for the revision or removal of gastric neurostimulator electrodes involves several key steps to ensure a safe and effective outcome. The process begins with the patient being placed under general anesthesia to ensure comfort and immobility during the surgery.
Following the laparoscopic revision or removal of gastric neurostimulator electrodes, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-procedure care may include pain management, instructions for wound care, and dietary modifications as the stomach heals. Patients are usually advised to avoid strenuous activities for a specified period to promote healing. Follow-up appointments are essential to assess recovery and determine if further interventions are necessary. Any signs of infection, such as increased redness, swelling, or discharge at the incision sites, should be reported to the healthcare provider immediately.
| Short Descr | LAP REVISE/REMV ELTRD ANTRUM | Medium Descr | LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM | Long Descr | Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | 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 | Hospital Part B services paid through a comprehensive APC | 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 |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 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). | 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. | 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.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2024-01-01 | Changed | Guideline information changed. |
| 2013-01-01 | Changed | Guideline information changed. |
| 2011-01-01 | Changed | Guideline information changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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