2025 CPT code 43282
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Laparoscopic repair of a paraesophageal hernia, including fundoplication if performed, with mesh implantation.
Modifiers may be applicable depending on the circumstances of the procedure.Examples include modifier 22 (increased procedural services), 59 (distinct procedural service), and others as determined by payer-specific guidelines.
The procedure is medically necessary when a paraesophageal hernia causes significant symptoms, such as dysphagia, heartburn, chest pain, or shortness of breath, that are not adequately managed with conservative measures.Documentation should support the need for surgical intervention and the choice of laparoscopic repair with mesh.
The surgeon is responsible for pre-operative assessment, patient preparation, anesthesia administration (if applicable), laparoscopic incision, insufflation of the abdomen, hernia reduction, diaphragmatic defect repair, mesh implantation, fundoplication (if performed), hemostasis, and closure of incisions. Anesthesiologists or CRNAs are responsible for anesthesia management. Other medical professionals may assist as appropriate.
- Surgery
- Surgical Procedures on the Digestive System > Surgical Procedures on the Esophagus > Laparoscopic Procedures on the Esophagus
In simple words: This code describes a minimally invasive surgery to fix a paraesophageal hernia, a condition where part of the stomach pushes up into the chest next to the esophagus.The surgeon uses small incisions, a camera, and special tools to repair the hernia and may also reinforce the repair with mesh.A procedure to wrap part of the stomach around the esophagus might also be done.
This CPT code encompasses the laparoscopic surgical repair of a paraesophageal hernia.The procedure involves the creation of small incisions in the abdomen, insufflation of carbon dioxide for improved visualization, and the insertion of laparoscopic instruments and a camera.The surgeon identifies the hernia, reduces any displacement of the stomach or intestines, repairs the diaphragmatic defect, and implants mesh to reinforce the repair.Fundoplication (wrapping a portion of the stomach around the lower esophagus) may be included if performed.Hemostasis is ensured, and the incisions are closed.
Example 1: A 65-year-old female presents with symptoms of dysphagia and chest pain.Endoscopy reveals a large paraesophageal hernia.Laparoscopic repair with mesh is performed, and fundoplication is deemed necessary due to significant gastroesophageal reflux disease (GERD). Code 43282 is reported., A 72-year-old male patient is diagnosed with a small paraesophageal hernia causing intermittent dyspnea.Laparoscopic repair with mesh is undertaken without fundoplication.Code 43282 is reported., A 50-year-old female patient underwent previous abdominal surgery resulting in adhesions.During laparoscopic paraesophageal hernia repair, the surgeon encountered significant adhesions, requiring additional time and effort for lysis. Code 43282 is reported, along with modifier 22 (increased procedural services) if applicable based on payer guidelines.
Preoperative diagnostic imaging (e.g., upper GI series, CT scan), operative report detailing the procedure, including the type and size of mesh used, the performance of fundoplication (if performed), and postoperative progress notes.The medical record should document the medical necessity of the procedure based on the patient's symptoms and clinical presentation.
** The inclusion of fundoplication is dependent on the surgeon's clinical judgment based on the patient's specific condition.Always refer to the latest CPT manual and payer-specific guidelines for the most accurate coding practices.The information provided here is for educational purposes only and should not be considered medical advice.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in source.Refer to CMS guidelines and local payer contracts for RVU values.
- Global Days: Information not available in source. The global period will vary depending on payer policies.
- Payment Status: Active
- Modifier TC rule: Information not available in source.Consult payer guidelines and related procedure documentation.
- Fee Schedule: Information not available in source.Consult historical fee schedules from CMS and other payers.
- Specialties:General Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, On Campus-Outpatient Hospital