How To Use CPT Code 43870

CPT 43870 describes the closure of a gastrostomy, which is a surgically created opening in the stomach for the insertion of a feeding tube. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43870?

CPT 43870 is used to describe the closure of a gastrostomy, which is a surgical procedure performed to close the opening in the stomach that was created for the purpose of inserting a feeding tube. This code is used when the provider makes an incision around the gastrostomy site, frees up the tract and the stomach, and closes the intervening stomach with sutures. The closure of the gastrostomy is necessary when the patient no longer requires the use of a feeding tube or when complications arise.

2. Official Description

The official description of CPT code 43870 is: ‘Closure of gastrostomy, surgical.’

3. Procedure

1. After the induction of general anesthesia, the provider makes an incision around the gastrostomy site.
2. The provider carries the incision down through the skin and subcutaneous tissue with sharp dissection.
3. The provider frees up the tract and the stomach.
4. The provider places stay sutures on either side of the tract.
5. The provider amputates the tract.
6. The provider closes the intervening stomach with interrupted Lembert sutures.
7. The provider closes the fascia and skin in layers.
8. The provider applies a dressing.

4. Qualifying circumstances

CPT 43870 is performed when the patient no longer requires the use of a gastrostomy tube or when complications arise that necessitate the closure of the gastrostomy. The procedure is typically performed by a qualified healthcare professional, such as a surgeon, who has the necessary skills and expertise to safely close the gastrostomy.

5. When to use CPT code 43870

CPT code 43870 should be used when the provider performs the closure of a gastrostomy surgically. It is important to note that this code is specific to the closure of a gastrostomy and should not be used for other procedures or interventions.

6. Documentation requirements

To support a claim for CPT 43870, the provider must document the following information:

• Indication for the closure of the gastrostomy
• Details of the procedure, including the incision, dissection, suturing, and dressing
• Any complications encountered during the procedure
• Post-procedure instructions and follow-up plans
• Signature of the provider performing the closure

7. Billing guidelines

When billing for CPT 43870, ensure that the closure of the gastrostomy is performed by a qualified healthcare professional. It is important to follow the specific guidelines provided by the payer to ensure accurate and timely reimbursement. It is also important to note that CPT code 43870 should not be reported with other codes unless there are separate and distinct procedures performed during the same operative session.

8. Historical information

CPT code 43870 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A surgeon performing the closure of a gastrostomy for a patient who no longer requires a feeding tube.
2. A gastroenterologist closing a gastrostomy due to complications that have arisen.
3. A pediatric surgeon performing the closure of a gastrostomy in a child who has outgrown the need for a feeding tube.
4. A general surgeon closing a gastrostomy in a patient with a healed gastrointestinal condition.
5. An interventional radiologist assisting in the closure of a gastrostomy using image guidance.
6. A surgical team performing the closure of a gastrostomy in a patient with a history of gastric cancer.
7. A gastroenterologist closing a gastrostomy in a patient with a resolved gastrointestinal obstruction.
8. A surgeon performing the closure of a gastrostomy in a patient with a healed perforated ulcer.
9. An interventional radiologist assisting in the closure of a gastrostomy in a patient with a healed esophageal injury.
10. A pediatric surgeon closing a gastrostomy in a child with a resolved congenital anomaly.