How To Use CPT Code 43840

CPT 43840 describes the procedure of suturing a tear in the stomach that may have occurred due to a gastric or duodenal ulcer, wound, or injury. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43840?

CPT 43840 can be used to describe the surgical procedure of suturing a perforated duodenal or gastric ulcer, wound, or injury in the stomach. This code is used when a provider makes an incision in the abdomen, explores the abdominal cavity, identifies the perforation, cleans the wound edges, and sutures it closed. The procedure may also involve the placement of a drain and closure of the abdomen in layers.

2. Official Description

The official description of CPT code 43840 is: ‘Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made in the abdomen to access the abdominal cavity.
3. The provider examines the stomach and surrounding structures for any injury or perforation.
4. If a perforation is found, the provider cleans the edges of the wound and sutures it closed.
5. A drain may be placed and brought out through an opening in the abdomen.
6. The provider performs a thorough examination of the stomach and surrounding structures, irrigating and suctioning as needed.
7. Instruments are removed, and the abdomen is closed in layers.

4. Qualifying circumstances

CPT 43840 is performed when there is a tear or perforation in the stomach, which may be caused by a gastric or duodenal ulcer, wound, or injury. The procedure is typically performed by a provider in response to a complication or emergency situation. It is important to note that this code should only be used for the repair of a perforated ulcer, wound, or injury in the stomach.

5. When to use CPT code 43840

CPT code 43840 should be used when a provider performs a gastric or duodenal ulcer repair by suturing a perforation in the stomach. It is appropriate to use this code when the procedure is performed as a standalone procedure or during the global period of another related procedure. However, it should not be reported if the repair is performed within the global period of a previous gastric or duodenal ulcer repair.

6. Documentation requirements

To support a claim for CPT 43840, the provider must document the following information:

• Patient’s diagnosis and indication for the procedure
• Description of the perforation, including its location and cause
• Date of the procedure
• Details of the procedure, including the incision, exploration, suturing, and placement of a drain
• Any additional procedures performed during the same operative session
• Complications, if any, encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 43840, ensure that the procedure meets the criteria for this code, including the repair of a perforated duodenal or gastric ulcer, wound, or injury. It is important to use the appropriate modifier if the procedure is performed during the global period of another related procedure. Additionally, be aware of any specific billing guidelines provided by payers or regulatory authorities.

8. Historical information

CPT 43840 was added to the Current Procedural Terminology system on January 1, 1990. It was initially listed as an inpatient-only (IPO) procedure but was later removed from the IPO list in 2021. However, in 2022, it was added back to the IPO list.

9. Examples

1. A patient presents with a perforated gastric ulcer. The provider performs a gastric suturing procedure to repair the perforation.
2. During a surgical exploration, a provider discovers a perforated duodenal ulcer. The provider proceeds to suture the perforation to close the wound.
3. An individual sustains a knife wound to the stomach, resulting in a perforation. The provider performs a gastric suturing procedure to repair the injury.
4. Following a gastric sleeve procedure, a patient develops a perforation in the stomach. The provider performs a gastric suturing procedure to repair the perforation during the global period of the initial surgery.
5. A patient with a history of gastric ulcers presents with a perforation. The provider performs a gastric suturing procedure to repair the perforation and prevent further complications.
6. During an exploratory laparotomy, a provider identifies a perforated gastric wound. The provider sutures the wound to close the perforation.
7. A patient involved in a car accident sustains a stomach injury resulting in a perforation. The provider performs a gastric suturing procedure to repair the injury.
8. Following a gastric bypass surgery, a patient experiences a perforation in the stomach. The provider performs a gastric suturing procedure to repair the perforation during the global period of the initial surgery.
9. An individual presents with a perforated duodenal ulcer. The provider performs a duodenal suturing procedure to repair the perforation.
10. During an emergency surgery, a provider discovers a perforated gastric ulcer. The provider proceeds to suture the perforation to close the wound.