Reimbursement Codes
COMMONLY USED CODES
| ICD-10-CM Diagnosis | |
|---|---|
| K21.0 | Gastro-esophageal reflux disease with esophagitis |
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| K30 | Functional dysphasia |
| R10.13 | Dyspepsia NOS |
| K44.9 | Diaphragmatic hernia without obstruction or gangrene |
| R12 | Heartburn |
| Note: Underlying condition(s) should also be coded. Consult an IC manual for a complete list of diagnosis codes. | |
| ICD-10-PCS Procedure Codes | |
|---|---|
| 0DV48DZ | Restriction of Esophagogastric Junction with Intraluminal Device, Via Natural or Artificial Opening Endoscopic |
| Note: ICD-10-PCS procedure codes are used specifically by hospitals to describe services and procedures provided during an in-patient confinement | |
| Associated DRGs | |
|---|---|
| MS-DRG 326 | Stomach, Esophageal and Duodenal Procedures with MCC |
| MS-DRG 327 | Stomach, Esophageal and Duodenal Procedures with CC |
| MS-DRG 328 | Stomach, Esophageal and Duodenal Procedures w/o CC/MCC |
| Associated CPT © Codes | |
|---|---|
| 43210 | Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed |
| 43281 | Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh |
| 43282 | Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh |
| Revenue Code | |
|---|---|
| 0278 | Other Implants |
| C Code | |
|---|---|
| C1889 | Implantable/insertable device, not otherwise classified |
Disclaimer
Health economic and reimbursement information provided by EndoGastric Solutions, Inc. (EGS) is gathered from third party sources and is subject to change without notice. The information contained in this reference is presented for information purposes only and does not constitute reimbursement or legal advice. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes and charges for services that are rendered. EGS recommends that you consult with your payers, reimbursement specialists and/or legal counsel regarding coverage, coding and payment matters. The codes referenced herein are not all-inclusive, are not intended to represent all coding options, and may not be appropriate for use in all circumstances. CPT five-digit codes, descriptions, two-digit modifiers and other data are copyright ©2020 American Medical Association. All rights reserved.