CPT Code 43280 | Description & Clinical Information

CPT 43280 describes a laparoscopic surgical procedure in which the provider wraps the upper portion of the stomach around the lower portion of the esophagus, commonly used for patients with gastroesophageal reflux.

Official Description

The CPT book defines CPT code 43280 as: “Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)”.

Billing Guidelines

Do not bill CPT code 43280 together with CPT codes 43279, 43281, or 43282.

To find codes for open esophagogastric fundoplasty, refer to CPT codes 43327 and 43328.

To perform a surgical procedure for augmenting the esophageal sphincter using laparoscopy and placing a device for augmentation, refer to CPT codes 43284 and 43285.

Use CPT code 43210 for performing a transoral esophagogastroduodenoscopy fundoplasty, whether partial or complete.

Clinical Information

The procedure described by CPT code 43280 involves the treatment of the esophageal opening, which can cause symptoms such as heartburn, reflux, or chest pain. This procedure is called a fundoplication and is used to treat gastroesophageal reflux disease (GERD).

To start the procedure, the patient is thoroughly prepped and anesthetized. The provider creates a small incision at the umbilicus and uses it as an entry point to the abdomen. Gas is then insufflated into the abdomen, which helps to lift the abdominal wall away from the organs and improves visualization of the site to be treated.

Multiple small incisions are then made, and the provider inserts a camera and instruments to perform the procedure. At this point, any adhesions found are taken down. If visibility is limited due to blood and clots in the abdomen, suction may be used to improve it before the procedure begins.

Identifying the esophagus and stomach is a key part of the procedure. If they are in the chest, then they need to be replaced in their normal anatomic positions. This allows the provider to use the tools to incise the fundus and wrap it around the distal esophagus.

Depending on the specifics of the case, the provider may decide to wrap the stomach completely or partially around the esophagus. This part of the procedure is called a Nissen or Toupet procedure, respectively. The structures are then stitched in place, and the provider assures hemostasis.

Finally, the small abdominal incisions are closed in layers. This minimizes scarring and reduces the risk of infection or other complications.

Fundoplication has been shown to be an effective treatment for GERD and is usually well-tolerated by patients. However, as with any surgical procedure, there are risks and potential complications, such as bleeding, infection, or damage to nearby organs or tissues.

Recovery time varies depending on the specifics of each case, but patients should expect to spend several days in the hospital and up to 6 weeks at home recovering. During this time, it is important to follow all post-operative instructions and attend all follow-up appointments with the provider to ensure proper healing.

In conclusion, the fundoplication procedure described by CPT code 43280 is an effective treatment for GERD symptoms. This minimally invasive procedure involves creating small incisions in the abdomen and wrapping the stomach around the esophagus to prevent reflux. While it does involve some risks and a recovery period, its benefits are well-established and can greatly improve patients’ quality of life.

Return to all the CPT codes for laparoscopic procedures on the esophagus.

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