How To Use CPT Code 43810

CPT 43810 describes a surgical procedure that involves creating a connection between the stomach and the duodenum, typically after a portion of either organ has been removed. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43810?

CPT 43810 is a code used to describe a surgical procedure in which a surgical connection is made between the stomach and the duodenum. This procedure is typically performed when a portion of either organ has been excised, and it is also known as a gastroduodenal anastomosis.

2. Official Description

The official description of CPT code 43810 is: ‘The provider creates a surgical connection between the stomach and the duodenum, typically after a portion of the stomach or duodenum has been excised; also known as a gastroduodenal anastomosis.’

3. Procedure

1. The surgeon begins by mobilizing the stomach and the first part of the duodenum, making an incision in the peritoneum on the lateral aspect of the duodenum.
2. Next, the surgeon divides the duodenum between clamps, just distal to the pylorus. The distal cut end of the duodenum is covered with gauze and set aside for further anastomosis.
3. The surgeon then brings the distal cut end of the stomach and the duodenum together without any tension between them.
4. A seromuscular stitch is applied on the posterior walls of the two organs, ensuring that the bowel ends lie apart. The stitches are tightened to bring the seromuscular layers into contact.
5. Finally, the stomach and duodenum are joined using sutures, which are continued to join the anterior walls of the two structures, completing the anastomosis.

4. Qualifying circumstances

CPT 43810 is performed when there is a need to create a surgical connection between the stomach and the duodenum. This procedure is typically done after a portion of either organ has been excised. It is important to note that this procedure is performed by a qualified surgeon.

5. When to use CPT code 43810

CPT code 43810 should be used when a surgeon performs a gastroduodenostomy, creating a connection between the stomach and the duodenum. This code is appropriate when a portion of either organ has been excised, and the surgeon performs the anastomosis. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 43810, the surgeon must document the following information:

• Patient’s diagnosis and the need for the gastroduodenostomy
• Details of the surgical procedure, including the specific steps performed
• Date of the procedure
• Any additional relevant information, such as the size of the excised portion or any complications encountered
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 43810, ensure that the procedure is performed by a qualified surgeon. It is important to accurately document the details of the procedure to support the use of this code. Additionally, be aware of any specific billing guidelines or requirements set by insurance providers or regulatory bodies.

8. Historical information

CPT 43810 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A surgeon performs a gastroduodenostomy to create a connection between the stomach and the duodenum after excising a portion of the stomach in a patient with gastric cancer.
2. During a surgical procedure, a surgeon removes a portion of the duodenum and performs a gastroduodenostomy to reconnect the remaining duodenum to the stomach.
3. A patient undergoes a gastroduodenostomy after a previous surgery resulted in the removal of a portion of both the stomach and duodenum.
4. A surgeon performs a gastroduodenostomy to create a connection between the stomach and the duodenum after excising a portion of the duodenum due to a blockage.
5. During a surgical procedure, a surgeon removes a portion of the stomach and performs a gastroduodenostomy to reconnect the remaining stomach to the duodenum.
6. A patient undergoes a gastroduodenostomy after a previous surgery resulted in the removal of a portion of both the stomach and duodenum.
7. A surgeon performs a gastroduodenostomy to create a connection between the stomach and the duodenum after excising a portion of the stomach to treat a perforation.
8. During a surgical procedure, a surgeon removes a portion of the duodenum and performs a gastroduodenostomy to reconnect the remaining duodenum to the stomach.
9. A patient undergoes a gastroduodenostomy after a previous surgery resulted in the removal of a portion of both the stomach and duodenum.
10. A surgeon performs a gastroduodenostomy to create a connection between the stomach and the duodenum after excising a portion of the duodenum due to a blockage.