# Robotic Paraesophageal Hernia Repair



## dpumford (May 15, 2012)

Hi:  I sure hope someone can assist me with this 

The surgeon did an Robotic assisted repair of paraesophageal hernia w/ mesh.

Pt was placed in reverse trendelenburg position.  Abdominal wall was prepared.  Six small incisions were taken, after inflating the peritoneal cavity with CO2 and robotic arms are docked.  

The liver was retraced and the hernia was reduced and the hernial sac was dissected and divided.  Gore-Tex mesh was placed...etc etc.

I am not sure what to use for the procedure..S9200 identifies this was done as robotic but not sure if I should code as via Laparotomy (43333) or thoracoabdominal (43337) Or maybe neither of these are correct ! 

Also is there any know coding guidelines for instances like this... I can not locate any..

Any assistance would be greatly appreciated!

Thank you!!


----------



## Lujanwj (May 15, 2012)

It's just a laparoscopic procedure.  Dr says they inflated the cavity which is the standard for a scope.  I'd suggested 43282 (based on your summary). You can use S2900 as a secondary to show that it was Robotic Assisted but there's no extra reimbursement for it.  S2900 is more of a tracking code and for CMS the status is 'I'.  Also, it doesn't add extra work or risk to the procedure.


----------

