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Official Description

Gastroduodenostomy

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 43810, known as gastroduodenostomy, is a surgical intervention that establishes a connection between the stomach and the duodenum without the need to remove any part of either organ. This approach is particularly significant as it allows for the restoration of gastrointestinal continuity while preserving the anatomical structures involved. During the procedure, the surgeon makes a midline incision in the abdomen to gain access to the stomach and duodenum. Once exposed, any adhesions that may be present are carefully lysed, allowing for better mobility of the organs. An incision is typically made along the greater curvature of the stomach, and the stomach is then divided at the gastroduodenal junction. The opening in the stomach is subsequently closed with sutures. Following this, the duodenum is sutured to the stomach in an end-to-side manner, which facilitates the passage of digestive contents from the stomach into the duodenum. Alternatively, the duodenum may be rotated to align with the stomach, allowing for a side-to-side connection. This method involves longitudinal incisions in both the stomach and duodenum, which are then sutured together. After the connection is established, the surgical site is irrigated, and drains may be placed as necessary to prevent fluid accumulation. Finally, the abdominal incision is closed in layers to ensure proper healing. This procedure is essential for patients requiring surgical intervention to address various gastrointestinal conditions while maintaining the integrity of the digestive tract.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The gastroduodenostomy procedure, coded as CPT® 43810, is indicated for various gastrointestinal conditions that necessitate the establishment of a direct connection between the stomach and the duodenum without resection. The following are specific indications for performing this procedure:

  • Peptic Ulcer Disease - Patients suffering from severe peptic ulcers that do not respond to medical management may require this procedure to alleviate symptoms and prevent complications.
  • Gastric Outlet Obstruction - This procedure is indicated for patients with gastric outlet obstruction due to conditions such as malignancy or scarring, which impede the normal passage of food from the stomach to the duodenum.
  • Benign Gastric Tumors - In cases where benign tumors are present, gastroduodenostomy may be performed to bypass the affected area while preserving the stomach and duodenum.

2. Procedure

The gastroduodenostomy procedure involves several critical steps to ensure successful surgical outcomes. The following outlines the procedural steps involved:

  • Step 1: Abdomen Access - The procedure begins with a midline incision in the abdomen, allowing the surgeon to access the stomach and duodenum. This incision is crucial for exposing the necessary anatomical structures for the surgery.
  • Step 2: Lysis of Adhesions - Once the abdomen is opened, any adhesions that may be present between the stomach, duodenum, and surrounding tissues are carefully lysed. This step is essential for mobilizing the stomach and duodenum, facilitating the subsequent surgical maneuvers.
  • Step 3: Incision in the Stomach - An incision is made in the stomach, typically along the greater curvature. This incision allows for the division of the stomach at the gastroduodenal junction, which is a critical point for establishing the connection with the duodenum.
  • Step 4: Division and Closure - The stomach and duodenum are divided at the gastroduodenal junction, and the opening in the stomach is closed with sutures. This closure is vital for maintaining the integrity of the stomach after the division.
  • Step 5: Suturing the Duodenum - Following the closure of the stomach, an incision is made in the duodenum, and it is sutured to the stomach in an end-to-side fashion. This connection allows for the passage of digestive contents from the stomach into the duodenum.
  • Step 6: Alternative Connection Method - Alternatively, the duodenum may be rotated to meet the stomach, allowing for a side-to-side connection. In this case, both the stomach and duodenum are incised longitudinally and sutured together, creating a new pathway for digestion.
  • Step 7: Wound Management - After the connection is established, the surgical wound is irrigated to reduce the risk of infection. Drains may be placed as needed to facilitate fluid drainage from the surgical site.
  • Step 8: Closure of the Incision - Finally, the abdominal incision is closed in layers, ensuring proper healing and minimizing complications associated with the surgical site.

3. Post-Procedure

Post-procedure care following a gastroduodenostomy is essential for ensuring patient recovery and minimizing complications. Patients are typically monitored for any signs of infection or complications related to the surgical site. Pain management is provided as needed, and patients may be advised on dietary modifications to facilitate healing. Gradual reintroduction of oral intake is common, starting with clear liquids and progressing to a regular diet as tolerated. Follow-up appointments are crucial for assessing recovery and ensuring that the surgical connection is functioning properly. Additionally, any drains placed during the procedure are monitored and managed according to standard postoperative protocols.

Short Descr GASTRODUODENOSTOMY
Medium Descr GASTRODUODENOSTOMY
Long Descr Gastroduodenostomy
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).
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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