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General Surgery Coding Alert

Reader Question:

Laparoscopic Repair of Diaphragmatic Hernia

Published on Wed Aug 01, 2001

Question: How can I code laparoscopic repair of a diaphragmatic hernia?

New Hampshire Subscriber  
Answer: There is no code for this procedure, says Marcella Bucknam, CPC, billing and compliance coordinator at the University of Nebraska Medical Centers department of surgery in Omaha. This service is included in a laparoscopic Nissen procedure (43280, laparoscopy, surgical, esophagogastric fundoplasty [e.g., Nissen, Toupet procedures]).
 
In the rare event that a diaphragmatic hernia is repaired without a lap Nissen, an unlisted laparoscopy code such as 43289 (unlisted laparoscopy procedure, esophagus) or 49659 (unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy) should be used. Because unlisted codes spur automatic review, clear and accurate documentation of the procedure should accompany the claim.  
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