Nicole Posted Thu 04th of December, 2014 11:30:41 AM
My provider did an endoscopic suture repair of a gastro-gastric fistula using the Apollo overstitch suturing system. He also used an ERBE laser to rough up the muscosa to help with closure.
Erbe laser device was set to 40, we coagulated the mucosa fo 2 cm arounf the edge of the fistula. This was to rough up the mucosa so that after closure this would close. Double channel therapeutic scope was then introduce and was backloaded with endosuturing device. This was introduced through the override scope into the tooth esophagus into the pouch. We could see the fistulous opening and the needle was then opened and a bite was taken a 11 o'clock on the suture. The need was then passed through the grasper and then pulled through, repositioned and another bite was taken at 5 o'clock opening the suture on both sides. we then passed the cinching device down after releasing the needle. Sutures were then tightened .
I cannot find a suitable code. 43270, or 43229 for ERBE but could not locate anything for endoscopic suture
SuperCoder Answered Fri 05th of December, 2014 15:43:38 PM
There is no listed code for Endoscopic suture repair of gastric fistula, you will have to use unlisted code 43999, Unlisted procedure, stomach.