General Surgery Coding Alert

Question: The surgeon documented a Jaboulay pyloroplasty: The third and fourth portions of the duodenum were mobilized, and the third portion of the duodenum was brought up to the area of the pylorotomy and directly attached to the area of longitudinal incision through the pylorus. Duodenotomy was made, and the backside of the Jaboulay pyloroplasty was performed. The anterior anastomosis was performed, and the anterior suture line was imbricated. How would I code this case?

North Carolina Subscriber

Answer: CPT does not provide a specific code for Jaboulay pyloroplasty. Based on the limited portion of the op note provided in your question, the most likely code for the procedure is 43810 (Gastroduodenostomy).

Caution: Most pyloroplasty services bundle into other procedures like enterectomies and bariatric surgery, so you'll need to examine the entire note to ensure that you can separately bill the Jaboulay pyloroplasty.

If a review of the entire note and/or patient history indicates that this code is not really appropriate, then the unlisted code 43999 (Unlisted procedure, stomach) would be your most likely recourse.