Reimbursement Codes

COMMONLY USED CODES

ICD-10-CM Diagnosis
K21.0Gastro-esophageal reflux disease with esophagitis
K21.9Gastro-esophageal reflux disease without esophagitis
K30Functional dyspepsia
R10.13Epigastric pain
K44.9Diaphragmatic hernia without obstruction or gangrene
R12Heartburn
Note: Underlying condition(s) should also be coded. Consult an IC manual for a complete list of diagnosis codes.
ICD-10-PCS Procedure Codes
0DV48DZRestriction 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 326Stomach, Esophageal and Duodenal Procedures with MCC
MS-DRG 327Stomach, Esophageal and Duodenal Procedures with CC
MS-DRG 328Stomach, Esophageal and Duodenal Procedures w/o CC/MCC
Associated CPT © Codes
43210Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed
43281Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh
43282Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh
Revenue Code
0278Other Implants
C Code
C1889Implantable/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.

NP02606-01B