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The procedure described by CPT® Code 43881 involves the implantation or replacement of gastric neurostimulator electrodes specifically within the antrum of the stomach. This intervention is primarily indicated for patients suffering from medically refractory gastroparesis, a condition characterized by delayed gastric emptying that does not respond to conventional treatments. Commonly referred to as a gastric pacemaker, this device aims to alleviate debilitating symptoms associated with gastroparesis, such as severe vomiting and nausea, by providing electrical stimulation to the stomach's nerves. The implantation process entails creating a subcutaneous pocket in the abdominal wall, typically beneath the rib cage, where the neurostimulator or generator component of the device is placed. Additionally, two intramuscular lead wires equipped with electrodes are inserted into the muscle wall of the stomach antrum. These electrodes deliver continuous high-frequency, low-energy electrical impulses, which promote gastric contractions and enhance the overall function of the stomach. This procedure is coded as 43881 for the initial implantation or replacement of the gastric neurostimulator electrodes, while code 43882 is designated for open revision or removal of previously placed electrodes.
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The implantation or replacement of gastric neurostimulator electrodes is indicated for patients with medically refractory gastroparesis. This condition is characterized by the stomach's inability to empty its contents properly, leading to severe symptoms that can significantly impact the patient's quality of life. The following are specific indications for this procedure:
The procedure for the implantation or replacement of gastric neurostimulator electrodes involves several critical steps, which are detailed as follows:
After the implantation or replacement of gastric neurostimulator electrodes, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-procedure care includes managing any discomfort or pain with prescribed medications. Patients may be advised to follow a specific diet and gradually reintroduce solid foods as tolerated. Follow-up appointments are essential to assess the device's functionality and make any necessary adjustments to the stimulation settings. Additionally, patients should be educated on signs of potential complications, such as infection or device malfunction, and instructed to seek medical attention if these occur.
| Short Descr | IMPL/REDO ELECTRD ANTRUM | Medium Descr | IMPLTJ/RPLCMT GASTRIC NSTIM ELTRDE ANTRUM OPEN | Long Descr | Implantation or replacement of gastric neurostimulator electrodes, antrum, open | 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 | 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 |
| 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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