2025 CPT code 43880
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Digestive System Feed
Closure of a gastrocolic fistula using various surgical techniques depending on the fistula's characteristics.
Modifiers 22 (increased procedural services), 51 (multiple procedures), 52 (reduced services), 78 (unplanned return to OR), 79 (unrelated procedure), and others may apply depending on the specific circumstances of the surgical intervention.Appropriate modifier selection requires detailed documentation.
Surgical closure of a gastrocolic fistula is medically necessary when the fistula causes significant symptoms (e.g., abdominal pain, weight loss, sepsis), threatens bowel integrity, or interferes with normal digestive function.Medical necessity should be documented based on clinical presentation and imaging findings.
The surgeon's responsibilities include preoperative assessment, surgical planning, performing the procedure (including exploration, fistula closure/resection, and anastomosis if needed), ensuring hemostasis, and postoperative care coordination.
In simple words: The surgeon repairs an abnormal connection between the stomach and colon.The approach depends on the specific situation, and may involve stitching the opening closed, or removing and reconnecting affected parts of the stomach and colon.
This CPT code encompasses the surgical closure of a gastrocolic fistula.The procedure involves abdominal incision, exposure of the stomach and colon, exploration to determine the fistula's extent, and isolation of its openings.Surgical techniques vary; they may include simple closure, laying open the fistula and suturing the tract, or resection of involved stomach and colon portions with subsequent anastomosis.Hemostasis and closure of the abdominal incision are integral parts of the procedure.
Example 1: A 65-year-old patient presents with a gastrocolic fistula following a previous gastric bypass surgery. The surgeon performs a laparotomy, identifies the fistula tract, and closes it primarily with sutures., A 50-year-old patient develops a gastrocolic fistula due to a perforated gastric ulcer. The surgeon performs a partial gastrectomy and partial colectomy, followed by an end-to-end anastomosis to close the fistula and restore bowel continuity., A 70-year-old patient has a complex gastrocolic fistula involving extensive inflammation and adhesion. The surgeon performs a staged procedure, initially cleaning the area and later closing the fistula after the inflammation subsides.
Complete history and physical examination, including details on the patient's symptoms, prior surgeries (if any), imaging studies (CT scan, barium studies) demonstrating the fistula, operative report detailing the surgical technique and findings, and pathology reports if tissue is resected.
** The complexity of the procedure and the extent of the resection, if any, influence the overall reimbursement.Accurate coding requires comprehensive documentation of the surgical approach and any complications encountered.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:General Surgery, Gastrointestinal Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center