How To Use CPT Code 39545

CPT 39545 describes the surgical procedure known as imbrication of the diaphragm for eventration. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 39545?

CPT 39545 is a code used to describe the surgical procedure called imbrication of the diaphragm for eventration. This procedure involves rearranging the connective tissue of the diaphragm in an overlapping manner to repair an extreme elevation of the diaphragm caused by the protrusion of abdominal organs. The surgery can be performed either through a transthoracic approach, accessing the diaphragm through the thorax, or through a transabdominal approach, accessing the diaphragm through the abdomen. It is important to note that the diaphragm may be paralyzed in some cases.

2. Official Description

The official description of CPT code 39545 is: ‘Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic.’

3. Procedure

1. The surgeon begins by approaching the diaphragm either through the thorax or the abdomen, depending on the chosen approach.
2. After inspecting the diaphragm and identifying the areas of damage, the surgeon returns the abdominal contents back into the abdomen.
3. The connective tissue attaching the diaphragm to the chest wall is then folded and sutured to restore the diaphragm to its natural position.
4. Finally, the incision is closed in layers to complete the procedure.

4. Qualifying circumstances

CPT 39545 is performed on patients who have an extreme elevation of the diaphragm due to the protrusion of abdominal organs, known as eventration. The procedure can be performed on both paralytic and nonparalytic diaphragms. It is important to note that this surgery is typically reserved for cases where other conservative treatments have failed to provide relief or improvement.

5. When to use CPT code 39545

CPT code 39545 should be used when a surgeon performs the imbrication of the diaphragm for eventration procedure. It is important to ensure that the patient meets the qualifying circumstances and that other conservative treatments have been exhausted before resorting to surgery.

6. Documentation requirements

To support a claim for CPT 39545, the surgeon must document the following information:

• Patient’s diagnosis of extreme elevation of the diaphragm due to eventration
• Details of the surgical approach (transthoracic or transabdominal)
• Specific areas of the diaphragm that were repaired
• Any complications or unexpected findings during the procedure
• Details of the closure of the incision
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 39545, it is important to ensure that the procedure meets the criteria for this specific code. The surgeon should use the appropriate modifier if necessary and follow any additional guidelines provided by the payer. It is also important to review any bundling or unbundling rules that may apply to this procedure.

8. Historical information

CPT 39545 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. It is worth noting that Medicare added this procedure to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A patient with extreme elevation of the diaphragm due to eventration undergoes a transthoracic imbrication procedure to restore the diaphragm to its natural position.
2. A surgeon performs a transabdominal imbrication of the diaphragm for eventration in a patient with nonparalytic diaphragm elevation.
3. An individual with paralytic diaphragm eventration undergoes a transthoracic procedure to repair the diaphragm and improve respiratory function.
4. A patient with extreme elevation of the diaphragm due to eventration undergoes a transabdominal imbrication procedure to alleviate symptoms and improve quality of life.
5. A surgeon performs a transthoracic imbrication of the diaphragm for eventration in a patient with paralytic diaphragm elevation.
6. An individual with nonparalytic diaphragm eventration undergoes a transabdominal procedure to restore the diaphragm to its natural position and improve respiratory function.
7. A patient with extreme elevation of the diaphragm due to eventration undergoes a transthoracic imbrication procedure to alleviate symptoms and improve quality of life.
8. A surgeon performs a transabdominal imbrication of the diaphragm for eventration in a patient with nonparalytic diaphragm elevation.
9. An individual with paralytic diaphragm eventration undergoes a transthoracic procedure to repair the diaphragm and improve respiratory function.
10. A patient with extreme elevation of the diaphragm due to eventration undergoes a transabdominal imbrication procedure to alleviate symptoms and improve quality of life.