CPT^® 43281, Under Laparoscopic Procedures on the Esophagus

The Current Procedural Terminology (CPT^®) code 43281 as maintained by American Medical Association, is a medical procedural code under the range - Laparoscopic Procedures on the Esophagus.

Additional/Related Information

Tabs

Summary

The provider performs repair of a paraesophageal hernia, where the stomach slides up next to the esophagus, using laparoscopy. He may also perform fundoplasty, wrapping part of the stomach around the esophagus. He does not implant mesh.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 43281 ? Start a discussion here

Hiatal Hernia repair and LINX procedure

I, too, have spent hours searching for additional info. The only other information I've been able to find on this subject agrees with the CPT Assistant, except that it does not state the HH had to be ... [ Read More ]

Hiatal Hernia repair and LINX procedure 43280 43281 43284 hiatal hernia linx

Any guidance would be GREATLY appreciated! We have surgeons who occasionally perform HH repairs along with LINX placement. We had been instructed by their main office to bill for the 43280/43281 HH re... [ Read More ]

code 43235

Please advice can code 43281 and 43235 can be billed together. We billed them together but code 43235 is denied as incidental to 43281... [ Read More ]

Laparocopic reduction of hiatal hernia without dissection

Looking for advice re: the case below. I am not certain if 43281 is supported as a full dissection of the sac did not occur. would only 43653 be warranted with perhaps modifier 22 for the work that wa... [ Read More ]

Laparocopic reduction of hiatal hernia without dissection

CPT 43281-59 BILLED WITH 43775

Would this support billing 43281 in addition to a bariatric procedure? The paraesophageal hernia was addressed first. The paraesophageal fat pad and the associated hernia sac were removed with a harm... [ Read More ]

paraesophageal hernia with biologic mesh 43280 vs 43282

Can you post the body of the operative report without patient details for a complete review? It is possible the surgeon did not describe the dissection of the hernia sac in detail leading to the confu... [ Read More ]

CPT 43281-59 BILLED WITH 43775

The short answer is it depends on the circumstances and documentation. It is bundled. CCI edits allow a modifier 59 to be applied to the 43281. However, use of modifier 59 is indicative of a "distinct... [ Read More ]

CPT 43281-59 BILLED WITH 43775

I keep getting denials for CPT 43281-59 as bundled with 43775. Even after the medical records are reviewed by the payer. Does anyone know if CPT code 43281 can ever be paid when billed with CPT 43775?... [ Read More ]

Hiatal hernia repair along with TIF procedure

I have 3 questions. 1) If a general surgeon does a laparoscopic hiatal hernia repair without mesh, is the correct code 43281? that surgeon leaves the room with patient stable and a second surgeon, a ... [ Read More ]

View All