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The procedure described by CPT® Code 43855 involves the revision of a gastroduodenal anastomosis, specifically a gastroduodenostomy, accompanied by a vagotomy. This surgical intervention is performed when there are complications at the site of a previous anastomosis, which is a surgical connection between the stomach and the duodenum. The abdomen is surgically opened to allow the surgeon to inspect the anastomosis site. Depending on the specific indication for the revision, various techniques may be employed. For instance, if there is a stricture, or narrowing, at the anastomosis site, the surgeon may incise the muscular wall longitudinally to relieve the stricture and then repair it transversely. Alternatively, if a perforation, or hole, is present at the anastomosis site, it can be repaired using sutures. In contrast to CPT® Code 43850, which describes a similar procedure without the vagotomy component, CPT® Code 43855 includes the cutting of the vagus nerve, the tenth cranial nerve responsible for innervating parts of the stomach and upper digestive tract. This step is crucial as it aims to reduce excessive acid production in the stomach, thereby helping to prevent the formation of peptic ulcers. During the procedure, the vagus nerve is carefully identified and separated from surrounding tissues, and the main vagal trunks are divided. After completing the revision and vagotomy, drains may be placed in the abdominal cavity as necessary, and the surgical incision is subsequently closed. This comprehensive approach addresses both the structural issues at the anastomosis site and the physiological factors contributing to complications.
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The procedure described by CPT® Code 43855 is indicated for specific complications associated with a gastroduodenal anastomosis. These indications include:
The procedure for CPT® Code 43855 involves several critical steps to ensure effective revision of the gastroduodenal anastomosis with vagotomy:
Post-procedure care following the revision of gastroduodenal anastomosis with vagotomy includes monitoring for any complications such as infection or leakage at the surgical site. Patients may require a modified diet to accommodate the changes in gastric function due to vagotomy. Additionally, healthcare providers will assess the patient's recovery progress and manage any pain or discomfort. Follow-up appointments are essential to ensure that the anastomosis is healing properly and to address any ongoing symptoms or concerns.
| Short Descr | REVISE STOMACH-BOWEL FUSION | Medium Descr | REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY | Long Descr | Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; with 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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