How To Use CPT Code 43880

CPT 43880 describes the closure of a gastrocolic fistula, which is a tract or abnormal passageway between the stomach and colon. 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 43880?

CPT 43880 is used to describe the closure of a gastrocolic fistula. This procedure is performed by a healthcare provider to repair the abnormal passageway between the stomach and colon. The specific technique used may vary depending on the individual case and the extent of the fistula.

2. Official Description

The official description of CPT code 43880 is: ‘Closure of gastrocolic fistula.’

3. Procedure

1. The healthcare provider begins by making an incision in the abdomen to access the stomach and colon.
2. They carefully explore the abdomen and locate the gastrocolic fistula.
3. Using a probe, they assess the extent of the tract and identify the openings of the fistula.
4. The provider then proceeds to close off the fistula using sutures or may choose to lay it open from end to end and obliterate the tract with sutures.
5. In some cases, the provider may need to remove a portion of the stomach and colon involved in the fistula and create an anastomosis, which is a connection between the two resected areas.
6. After ensuring there is no bleeding and removing any instruments, the provider closes the abdominal incision in layers.

4. Qualifying circumstances

CPT 43880 is used when a patient has a gastrocolic fistula resulting from prior gastroenteric or bariatric surgery or from untreated gastric ulcers. The procedure is performed by a healthcare provider who has determined that closure of the fistula is necessary to improve the patient’s condition.

5. When to use CPT code 43880

CPT code 43880 should be used when a healthcare provider performs the closure of a gastrocolic fistula. It is important to ensure that the procedure performed matches the description provided by the code. If a different type of fistula closure is performed, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 43880, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of a gastrocolic fistula
• Details of the procedure performed, including any specific techniques used
• Date of the procedure
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 43880, it is important to ensure that the procedure performed matches the description provided by the code. The healthcare provider should also follow any specific billing guidelines provided by the payer. It is important to review the documentation requirements and ensure that all necessary information is included in the claim.

8. Historical information

CPT 43880 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A healthcare provider performs the closure of a gastrocolic fistula resulting from a previous gastric bypass surgery.
2. A patient with an untreated gastric ulcer undergoes a procedure to close the gastrocolic fistula.
3. A healthcare provider performs the closure of a gastrocolic fistula that developed after a bariatric surgery procedure.
4. A patient with a history of gastric surgery requires the closure of a gastrocolic fistula to improve their condition.
5. A healthcare provider performs the closure of a gastrocolic fistula that was causing significant symptoms and complications for the patient.