2025 CPT code 39503
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Mediastinum and Diaphragm Feed
Repair of neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of a ventral hernia.
Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), and others may be applicable depending on the circumstances of the procedure.
Medical necessity for this procedure is established by the presence of a congenital diaphragmatic hernia that compromises the newborn's respiratory function and/or prevents normal development of the lungs.Supporting documentation, such as imaging studies and clinical findings, should be present in the patient's medical record.
The surgeon is responsible for the entire procedure, from prepping and anesthetizing the patient to closing the incision. This includes making the incision, removing the hernia sac, repositioning the organs, closing the diaphragmatic defect, and inserting any necessary drains.
In simple words: This procedure fixes a birth defect where a baby's diaphragm (the muscle separating the belly and chest) has a hole in it. This hole allows organs from the belly to move into the chest, making it hard for the lungs to grow. The surgeon makes a cut in the baby's belly, puts the organs back in place, and fixes the hole in the diaphragm. Sometimes a chest tube is needed, and a new hernia may be created in the belly during the repair.
This code describes a surgical procedure to repair a diaphragmatic hernia in a newborn.The diaphragm muscle may not be completely formed, allowing abdominal organs to move into the chest cavity, hindering lung development. The procedure may include chest tube insertion and creation of a ventral hernia.The surgeon makes an incision in the abdomen, removes the hernia sac, and repositions the herniated organs.The hole in the diaphragm is closed with stitches or a mesh graft.A drain is placed, and the incision is closed.
Example 1: A newborn is diagnosed with a congenital diaphragmatic hernia where the stomach and intestines have entered the chest cavity. Code 39503 is used for the open surgical repair., A newborn requires surgical repair of a diaphragmatic hernia. During the procedure, the surgeon places a chest tube to aid in lung expansion. Code 39503 is reported., A newborn with a large diaphragmatic defect undergoes repair with the placement of a mesh graft to close the defect. In addition, a ventral hernia is created to reduce tension on the repair. Code 39503 is reported.
Documentation should include operative report detailing the size and location of the diaphragmatic defect, organs involved, type of repair (primary closure vs. mesh), use of chest tube, and creation of a ventral hernia (if applicable). Pre- and postoperative diagnoses, and any complications should be documented.
- Revenue Code: P1G - MAJOR PROCEDURE - OTHER
- Specialties:Pediatric Surgery, Neonatal Surgery, Thoracic Surgery
- Place of Service:Inpatient Hospital