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2025 CPT code 43285

Removal of an esophageal sphincter augmentation device via laparoscopy.

Consult the current CPT® coding guidelines for laparoscopic procedures and surgical procedures of the esophagus for proper coding practices.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT® guidelines and payer-specific guidelines for details.

Removal of the esophageal sphincter augmentation device must be medically necessary, such as due to device malfunction, complications, or lack of clinical benefit. Appropriate documentation supporting medical necessity is required for reimbursement.

The surgeon is responsible for pre-operative patient assessment, obtaining informed consent, performing the laparoscopic procedure, post-operative care, and follow up.

IMPORTANT:Code 43284 is used for the placement of the esophageal sphincter augmentation device.Diagnostic laparoscopy (peritoneoscopy) is coded separately using 49320 if performed.

In simple words: The doctor removes a magnetic band from around the junction of the esophagus and stomach using a minimally invasive laparoscopic technique. This band was previously placed to help prevent stomach acid from flowing back into the esophagus (GERD).

Laparoscopic removal of an esophageal sphincter augmentation device.This procedure involves the use of a laparoscope to visualize the gastroesophageal junction and remove a magnetic band (or similar device) used to augment the lower esophageal sphincter. The procedure includes the creation of small incisions, insufflation of the abdomen, insertion of laparoscopic instruments, removal of the device, and closure of the incisions.

Example 1: A patient with persistent gastroesophageal reflux disease (GERD) despite medical management undergoes laparoscopic removal of a previously placed magnetic sphincter augmentation device due to complications or inefficacy., A patient experiences adverse effects, such as discomfort or migration of the magnetic band, following placement of an esophageal sphincter augmentation device, necessitating laparoscopic removal., A patient's condition improves after placement of the device, rendering the device no longer medically necessary, leading to a decision for its removal via laparoscopy.

* Preoperative assessment including patient history, physical exam, and relevant investigations (e.g., endoscopy, manometry).* Operative report detailing the laparoscopic procedure, including the type of device removed and any complications.* Postoperative progress notes documenting the patient's recovery and any complications.* Imaging studies (if any) demonstrating the device's location and removal.

** Payers may have specific coverage policies for the removal of esophageal sphincter augmentation devices.It is essential to verify coverage prior to performing the procedure.Always refer to the most recent CPT® and payer guidelines for the most up-to-date information.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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