How To Use CPT Code 43881

CPT 43881 describes the implantation or replacement of gastric neurostimulator electrodes on the antrum of the stomach. 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 43881?

CPT 43881 is used to describe the surgical procedure of placing or replacing gastric neurostimulator electrodes on the antrum of the stomach. This procedure is performed to treat nausea and vomiting caused by gastroparesis, a condition characterized by paralysis of the stomach muscles. It is typically used when drug therapy has not been effective in managing the symptoms of gastroparesis, which can be a complication of diabetes.

2. Official Description

The official description of CPT code 43881 is: ‘Implantation or replacement of gastric neurostimulator electrodes, antrum, open.’

3. Procedure

1. The patient is positioned supine on the operating table and prepared and anesthetized appropriately.
2. An upper midline incision is made by the provider.
3. Once the abdomen is accessed and the cavity is visualized, any adhesions are taken down.
4. The provider mobilizes the stomach and identifies the antrum.
5. Gastric neurostimulator electrodes are positioned on the antrum and anchored in place.
6. A pocket is created in the abdomen just below the skin, and the generator is placed in the pocket.
7. The electrodes are connected to the pulse generator.
8. If the patient has previously placed electrodes and generator, the nonworking electrodes may be removed, new ones placed on the antrum, and connected to the generator.
9. A programmer tests the electrodes and programs the settings.
10. The provider checks for bleeding, removes any instruments, and closes the abdominal incision in layers.

4. Qualifying circumstances

CPT 43881 is performed on patients with gastroparesis, a condition characterized by paralysis of the stomach muscles. This procedure is typically reserved for patients who have not responded to drug therapy and are experiencing severe nutritional deficits. It is important to note that the use of gastric neurostimulator electrodes for weight loss is not approved.

5. When to use CPT code 43881

CPT code 43881 should be used when the provider performs the implantation or replacement of gastric neurostimulator electrodes on the antrum of the stomach. It is important to ensure that the patient meets the qualifying circumstances for this procedure and that other treatment options have been exhausted.

6. Documentation requirements

To support a claim for CPT 43881, the provider must document the following information:

• Patient’s diagnosis of gastroparesis and the need for the implantation or replacement of gastric neurostimulator electrodes
• Details of the procedure, including the specific steps performed
• Date of the procedure
• Any complications or adverse events encountered
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 43881, ensure that the procedure involves the implantation or replacement of gastric neurostimulator electrodes on the antrum of the stomach. It is important to follow the specific guidelines provided by the payer and to accurately report the procedure code. Additionally, it is essential to review any bundling or unbundling rules that may apply to this procedure.

8. Historical information

CPT 43881 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates or changes to the code since its addition. However, it is important to stay updated with any changes in coding guidelines or regulations that may affect the reporting of this procedure.

9. Examples

1. A patient with gastroparesis undergoes an open procedure for the implantation of gastric neurostimulator electrodes on the antrum of the stomach.
2. A provider replaces the nonworking gastric neurostimulator electrodes on the antrum of the stomach with new ones in a patient with gastroparesis.
3. An individual with gastroparesis undergoes an open procedure for the implantation of gastric neurostimulator electrodes on the antrum of the stomach to alleviate their symptoms of nausea and vomiting.
4. A patient with gastroparesis requires the replacement of gastric neurostimulator electrodes on the antrum of the stomach due to device malfunction.
5. A provider performs an open procedure to implant gastric neurostimulator electrodes on the antrum of the stomach in a patient with gastroparesis who has not responded to drug therapy.
6. A patient with gastroparesis undergoes a revision procedure to remove the existing gastric neurostimulator electrodes from the antrum of the stomach.
7. An individual with gastroparesis requires the replacement of gastric neurostimulator electrodes on the antrum of the stomach to improve their symptoms of nausea and vomiting.
8. A provider performs an open procedure to implant gastric neurostimulator electrodes on the antrum of the stomach in a patient with gastroparesis who has exhausted other treatment options.
9. A patient with gastroparesis undergoes a revision procedure to remove the nonworking gastric neurostimulator electrodes from the antrum of the stomach and replace them with new ones.
10. An individual with gastroparesis requires the implantation of gastric neurostimulator electrodes on the antrum of the stomach to alleviate their symptoms and improve their nutritional status.