In simple words: If your esophagus is too short for a standard anti-reflux surgery, the surgeon can lengthen it during the same operation by creating a short extension from your stomach. This is done using minimally invasive tools and is reported in addition to the main procedure performed.

This add-on code describes an esophageal lengthening procedure, such as a Collis gastroplasty, performed during the same surgical session as a separately reportable primary procedure on the esophagus, like a fundoplasty, esophagomyotomy, or paraesophageal hernia repair. The Collis gastroplasty involves creating a tube from the upper part of the stomach, often using a stapler and bougie, to extend a shortened esophagus. This is typically done for patients with conditions like GERD or hiatal hernias where the esophagus is too short for a tension-free fundoplication.

Example 1: A patient with severe GERD and a shortened esophagus undergoes a laparoscopic Nissen fundoplication (43280) and a Collis gastroplasty (43338) to lengthen the esophagus and allow for a tension-free wrap., A patient with a paraesophageal hernia (43334) also requires esophageal lengthening (43338) during the hernia repair to prevent recurrence due to tension on the esophagus., A patient with achalasia undergoes an esophagomyotomy (43327) and a Collis gastroplasty (43338) because the shortened esophagus would create tension on the myotomy site.

Documentation should support the medical necessity of both the primary procedure and the esophageal lengthening. The operative report should clearly describe the technique used for the Collis gastroplasty, the length of the extension created, and the primary procedure performed.