2025 CPT code 43337
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Repair of paraesophageal hiatal hernia (including fundoplication) via thoracoabdominal incision, with implantation of mesh or other prosthesis, except neonatal.
Modifiers may apply based on specific circumstances. Refer to iFrameAI for specific details.
Medical necessity must be established by documenting the patient's symptoms, diagnostic studies confirming the presence and severity of the paraesophageal hernia (e.g., barium swallow, upper endoscopy), and failed conservative management attempts (if applicable). The documentation should also demonstrate the impact of the hernia on the patient's quality of life and the appropriateness of surgical intervention.
The surgeon makes incisions in the abdomen and chest, visualizes the hiatus, removes adhesions, and accesses the herniated portion of the stomach. The stomach is returned to the abdomen, an esophageal bougie may be used for dilation, and the diaphragmatic esophageal hiatus might be narrowed with sutures. Fundoplication is performed by wrapping the gastric fundus around the gastroesophageal junction. Mesh or prosthesis is implanted for reinforcement, the bougie is removed, bleeding is controlled, and the incisions are closed.
In simple words: The surgeon makes an incision in the abdomen and chest to repair a hiatal hernia where the stomach has moved up next to the esophagus. The operation involves wrapping part of the stomach around the esophagus and using a mesh to reinforce the repair. This procedure is not for newborns.
Through an incision in the abdomen and chest, the provider repairs a paraesophageal hiatal hernia, where the stomach slides up next to the esophagus. The procedure includes fundoplication and the use of mesh or another prosthetic implant. This code is not appropriate for newborns.
Example 1: A 50-year-old patient presents with a symptomatic paraesophageal hiatal hernia where the fundus of the stomach has herniated into the chest beside the esophagus. The surgeon performs a thoracoabdominal approach, reduces the hernia, performs a fundoplication, and reinforces the repair with mesh., A 35-year-old patient with a recurrent paraesophageal hernia undergoes repair via a thoracoabdominal incision. The surgeon uses a prosthetic material to reinforce the diaphragmatic hiatus during the fundoplication., A 60-year-old patient experiences severe heartburn and regurgitation due to a large paraesophageal hernia. Surgical repair is performed using a combined thoracoabdominal approach, including fundoplication and mesh placement.
Operative report detailing the surgical approach (thoracoabdominal), hernia reduction, fundoplication technique, type of mesh or prosthesis used, and any intraoperative findings or complications.
- Global Days: Global Days: Refer to iFrameAI for specific details.
- Modifier TC rule: Refer to iFrameAI for specific details.
- Fee Schedule: Refer to iFrameAI for specific details.
- Specialties:Thoracic Surgery, General Surgery
- Place of Service:Inpatient Hospital