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2025 CPT code 43651

Laparoscopic truncal vagotomy.

Surgical laparoscopy always includes diagnostic laparoscopy. Code 49320 should not be reported separately with 43651.

Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), etc., may be applicable depending on the circumstances.

Medical necessity must be established by documenting the patient's condition, failed conservative treatments, and the rationale for surgical intervention.

The surgeon performs the laparoscopic procedure, making incisions, inserting instruments, mobilizing organs, transecting the vagus nerves, controlling bleeding, and closing the incisions.

IMPORTANT:For selective or highly selective vagotomy, use 43652. For open vagotomy, use 43640 (truncal or selective) or 43641 (highly selective).

In simple words: The surgeon makes small cuts in the belly and inserts a tiny camera and tools to cut the vagus nerves, which helps reduce stomach acid.

This code describes a procedure where the surgeon uses a laparoscope to cut the main trunks of the vagus nerve. This procedure is typically performed to reduce stomach acid production and treat duodenal ulcers.

Example 1: A patient with a chronic duodenal ulcer not responding to medication undergoes a laparoscopic truncal vagotomy to reduce stomach acid secretion., A patient with recurrent bleeding ulcers undergoes laparoscopic truncal vagotomy as part of a larger surgical procedure., A patient with Zollinger-Ellison syndrome (a condition causing excessive stomach acid) undergoes a laparoscopic truncal vagotomy to alleviate symptoms.

Documentation should include operative report detailing the laparoscopic approach, identification and transection of the vagus nerve trunks, any associated procedures performed, and post-operative status.

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