2025 CPT code 43279
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Laparoscopic esophagomyotomy, with or without fundoplasty
Modifiers may be applicable to this code to indicate specific circumstances of the procedure.For example, modifier 22 may be used to indicate increased procedural services.
Medical necessity should be established by documenting the patient's symptoms and diagnostic findings that justify the procedure.For achalasia, this may include manometry and barium swallow studies. For GERD, documentation may include upper endoscopy, pH monitoring, and response to medical therapy.
The physician is responsible for the entire surgical procedure, from prepping and anesthetizing the patient to performing the laparoscopic esophagomyotomy and possible fundoplasty, ensuring hemostasis, and closing the incisions.
In simple words: The surgeon uses a tiny camera and small tools inserted through small cuts in your belly to cut a muscle in your esophagus. This helps food pass into your stomach more easily. Sometimes, the surgeon also wraps part of your stomach around your esophagus to prevent reflux.
The physician performs a laparoscopic esophagomyotomy, which involves cutting an esophageal muscle.A fundoplasty, wrapping part of the stomach around the esophagus, may also be performed. The procedure begins with a small incision at the umbilicus to insufflate the abdomen. Additional small incisions are made to insert a camera and instruments. Adhesions are removed, and suction may be used to clear the surgical field.The surgeon identifies the esophagus and stomach and makes incisions through the superficial layers of the esophagus, lower esophageal sphincter, and stomach, leaving the inner layer intact.If a fundoplasty is performed, a flap from the stomach is wrapped around the distal esophagus to help the sphincter close properly and limit reflux. Hemostasis is achieved, and the abdominal incisions are closed.
Example 1: A patient with esophageal achalasia undergoes a laparoscopic esophagomyotomy to improve swallowing and food passage into the stomach., A patient with gastroesophageal reflux disease (GERD) undergoes a laparoscopic esophagomyotomy with fundoplasty to reduce reflux., A patient with achalasia has a laparoscopic esophagomyotomy without fundoplasty as a primary surgical treatment.
Documentation should include operative notes detailing the procedure, including the type of fundoplasty if performed (e.g., Nissen, Toupet), the presence or absence of adhesions, any complications encountered, and confirmation of hemostasis. Preoperative diagnostic reports supporting the medical necessity of the procedure should also be included.
** As of 2017, this code has been added to the Inpatient Only (IPO) list.
- Payment Status: Active
- Specialties:General Surgery, Thoracic Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital