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The procedure described by CPT® Code 43850 involves the revision of a gastroduodenal anastomosis, specifically a gastroduodenostomy, without the performance of vagotomy. A gastroduodenostomy is a surgical connection made between the stomach and the duodenum, which is the first part of the small intestine. This procedure is typically indicated when there are complications at the site of the previous anastomosis, such as strictures or perforations. During the revision, the abdomen is surgically opened to allow for direct inspection of the anastomosis site. The specific steps taken during the revision depend on the underlying issue that necessitated the procedure. For instance, if a stricture is present, the muscular wall at the anastomosis may be incised longitudinally to relieve the narrowing, followed by a transverse repair of the stricture. In cases where a perforation has occurred, sutures are used to repair the damaged area. It is important to note that this particular code does not involve vagotomy, which is a procedure that entails cutting the vagus nerve to reduce acid production in the stomach, a step that is included in the related CPT® Code 43855. After the necessary revisions are made, the vagus nerve is identified and freed from surrounding tissues, and drains may be placed in the abdomen as required before closing the incision. This comprehensive approach ensures that the complications at the anastomosis site are effectively addressed while maintaining the integrity of the surrounding structures.
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The revision of gastroduodenal anastomosis (gastroduodenostomy) is performed for specific indications that may arise due to complications at the anastomosis site. These indications include:
The procedure for revising a gastroduodenal anastomosis involves several critical steps, which are detailed as follows:
Post-procedure care following the revision of a gastroduodenal anastomosis includes monitoring for any signs of complications, such as infection or leakage at the anastomosis site. Patients may require supportive care, including pain management and nutritional support, as they recover from surgery. The surgical team will provide specific instructions regarding activity restrictions and follow-up appointments to ensure proper healing and assess the success of the revision.
| Short Descr | REVISE STOMACH-BOWEL FUSION | Medium Descr | REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY | Long Descr | Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy | 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 | Not applicable/unspecified. | CCS Clinical Classification | 94 - Other OR upper GI therapeutic procedures |
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| 2021-12-31 | Deleted | Code deleted |
| Pre-1990 | Added | Code added. |
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