How To Use CPT Code 43622

CPT 43622 describes a surgical procedure that involves the removal of the entire stomach and the creation of an intestinal pouch to maintain a continuous digestive tract. This article will provide an overview of CPT code 43622, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 43622?

CPT 43622 is a code used to describe a surgical procedure in which the provider removes the entire stomach and creates an intestinal pouch between the esophagus and duodenum. This procedure is typically performed on patients with stomach cancer or other conditions that require the removal of the stomach. It is important to note that CPT code 43622 should not be used for partial excision of the stomach.

2. Official Description

The official description of CPT code 43622 is the following: ‘Gastrectomy, total; with formation of intestinal pouch, any type.’ This code specifically refers to the complete removal of the stomach and the creation of an intestinal pouch to maintain a continuous digestive tract. It is important to review any additional notes or guidelines provided by the coding authorities for accurate reporting.

3. Procedure

1. The surgical procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an upper left paramedian incision in the abdomen to access the stomach.
3. The spleen and pancreas are freed up, and the stomach, along with the lesser and greater omentum and surrounding lymph nodes, is excised.
4. The arteries feeding the stomach are ligated or tied off to prevent bleeding.
5. The provider then creates an intestinal pouch between the esophagus and duodenum to replace the removed stomach.
6. There are various techniques available to create the pouch, such as anastomosing a loop of jejunum side to side with the esophagus and duodenum.
7. The provider sutures the cut ends of the esophagus and duodenum to each other, restoring an uninterrupted digestive tract.
8. A drain may be placed in the abdominal cavity, and the incision is closed in layers.

4. Qualifying circumstances

CPT code 43622 is typically used for patients with stomach cancer or other conditions that require the complete removal of the stomach. It is important to note that this code should not be used for partial excision of the stomach. The procedure must involve the creation of an intestinal pouch between the esophagus and duodenum to maintain a continuous digestive tract.

5. When to use CPT code 43622

CPT code 43622 should be used when the provider performs a total gastrectomy and creates an intestinal pouch to replace the removed stomach. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves partial excision of the stomach or does not include the creation of an intestinal pouch, a different code should be used.

6. Documentation requirements

When reporting CPT code 43622, the provider must document the following information:

• Patient’s diagnosis necessitating the total gastrectomy and creation of an intestinal pouch
• Details of the surgical procedure, including the specific technique used to create the pouch
• Date of the procedure
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Postoperative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 43622, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The code should not be reported for partial excision of the stomach or procedures that do not involve the creation of an intestinal pouch. It is also important to review any additional guidelines or instructions provided by the coding authorities or payers to ensure accurate reporting.

8. Historical information

CPT code 43622 was added to the Current Procedural Terminology system on January 1, 1994. It is important to stay updated with any changes or revisions to the code to ensure accurate reporting.

9. Examples

1. A patient with stomach cancer undergoes a total gastrectomy with the creation of an intestinal pouch to maintain a continuous digestive tract.
2. A provider performs a total gastrectomy with the formation of an intestinal pouch for a patient with a rare gastrointestinal disorder.
3. A patient with a history of gastric ulcers undergoes a total gastrectomy and the creation of an intestinal pouch to alleviate symptoms and improve quality of life.
4. A provider performs a total gastrectomy with the formation of an intestinal pouch as part of a treatment plan for a patient with a genetic predisposition to stomach cancer.
5. A patient with a large gastric tumor undergoes a total gastrectomy and the creation of an intestinal pouch to remove the cancerous tissue and maintain digestive function.
6. A provider performs a total gastrectomy with the formation of an intestinal pouch for a patient with a rare autoimmune condition affecting the stomach.
7. A patient with a history of chronic gastritis undergoes a total gastrectomy and the creation of an intestinal pouch to alleviate symptoms and improve overall health.
8. A provider performs a total gastrectomy with the formation of an intestinal pouch for a patient with a hereditary condition that increases the risk of stomach cancer.
9. A patient with a large gastric polyp undergoes a total gastrectomy and the creation of an intestinal pouch to remove the polyp and prevent further complications.
10. A provider performs a total gastrectomy with the formation of an intestinal pouch as part of a treatment plan for a patient with a rare metabolic disorder affecting the stomach.