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The CPT® Code 43831 refers to an open gastrostomy procedure specifically performed for neonatal feeding. This surgical intervention is designed to create an opening in the stomach of a neonate, allowing for the direct placement of a feeding tube. The procedure is critical for infants who are unable to feed orally due to various medical conditions. The technique involves making a small incision in the midline of the upper abdomen, through which the surgeon accesses the stomach. The procedure is similar to that described in CPT® Code 43830, with the primary distinction being its application in neonates. The process includes careful manipulation of the stomach and surrounding tissues to ensure proper placement of the feeding tube while minimizing trauma to the abdominal cavity. This procedure is essential for providing nutrition to neonates who require alternative feeding methods, ensuring their growth and development when oral feeding is not feasible.
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The open gastrostomy procedure coded as CPT® 43831 is indicated for neonates who require nutritional support through a feeding tube due to various medical conditions. These conditions may include, but are not limited to, congenital anomalies, neurological disorders, or other health issues that impair the ability to feed orally. The procedure is essential for ensuring that these infants receive adequate nutrition for growth and development when traditional feeding methods are not possible.
The open gastrostomy procedure involves several detailed steps to ensure the safe and effective placement of a feeding tube in a neonate. The process begins with the surgeon making a small incision in the midline of the upper abdomen. This incision allows access to the peritoneum, which is then grasped with forceps and incised to open the abdominal cavity. Once the cavity is accessed, any adhesions along the inner abdominal wall are lysed to facilitate a clear working area. The anterior aspect of the stomach is then grasped, and two concentric purse-string sutures are placed around the planned incision site on the stomach. The serosa of the stomach is incised at the center of these sutures, allowing the inner mucosal layer to be grasped and a small portion excised. This excision creates an opening in the mucosa, which is subsequently dilated to accommodate the insertion of a balloon catheter. The catheter is carefully inserted into the stomach, and the balloon is inflated to secure its position. Traction is applied to the external catheter to ensure that the balloon is pressed against the stomach wall. The purse-string sutures are then tightly tied around the catheter to maintain its position. Following this, the stomach is positioned against the abdominal wall, and the site for the abdominal incision is determined. A stab incision is made in the abdomen, and forceps are used to reach into the abdominal cavity to grasp the catheter and exteriorize it. Finally, anchoring sutures are placed on the internal abdominal wall, and the abdominal incision is closed in layers to complete the procedure.
After the open gastrostomy procedure is completed, careful post-procedure care is essential to ensure proper healing and function of the feeding tube. The neonate will be monitored for any signs of complications, such as infection or leakage around the stoma site. It is important to maintain the cleanliness of the stoma and the surrounding skin to prevent infection. The healthcare team will provide instructions on how to care for the feeding tube, including how to clean it and how to ensure it remains patent. Nutritional support will be initiated as per the neonate's needs, and follow-up appointments will be scheduled to assess the healing process and the effectiveness of the feeding tube. Parents or caregivers will receive education on feeding techniques and signs of potential complications to watch for at home.
| Short Descr | GASTROSTOMY OPEN NEONATAL | Medium Descr | GASTROSTOMY OPEN NEONATAL FOR FEEDING | Long Descr | Gastrostomy, open; neonatal, for feeding | 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 | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 71 - Gastrostomy, temporary and permanent |
| 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| Pre-1990 | Added | Code added. |
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