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Laparoscopic repair of repair of diaphragm laceration

Cindy Posted Thu 27th of August, 2015 07:53:41 AM

My surgeon had a patient with multiple stab wounds. Her performed a VATS procedure for evacuation of hemothorax. He then performed a diagnostic laparoscopy with repair of diaphragm laceration. I have been unable to find a cpt code for this done laparoscopically. Can you please advise what procedure would be appropriate for this procedure.

SuperCoder Answered Fri 28th of August, 2015 01:05:35 AM

Please read the attached question-answer on diaphragm repair laparoscopically.

Patient underwent laparoscopic diaphragmatic repair. Can you tell me what CPT code to use since there doesn't seem to be a laparoscopic code. Open is 39501, but laparoscopic not able to find.

There is no code for this procedure, says Marcella Bucknam, CPC, billing and compliance coordinator at the University of Nebraska Medical Centers department of surgery in Omaha. This service is included in a laparoscopic Nissen procedure (43280, laparoscopy, surgical, esophagogastric fundoplasty [e.g., Nissen, Toupet procedures]).
In the rare event that a diaphragmatic hernia is repaired without a lap Nissen, an unlisted laparoscopy code such as 43289 (unlisted laparoscopy procedure, esophagus) or 49659 (unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy) should be used. Because unlisted codes spur automatic review, clear and accurate documentation of the procedure should accompany the claim.

Thank you. I will use 43289, diaphragm repair was done secondary to injury done during a surgical procedure by another M.D.

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