CPT® Code 39503

The procedure described by CPT® Code 39503 pertains to the surgical repair of a neonatal diaphragmatic hernia, which is a congenital defect where abdominal contents herniate into the thoracic cavity due to an abnormal opening in the diaphragm. There are two primary types of neonatal diaphragmatic hernias: the Bochdalek hernia, which typically occurs on the left side and involves herniation of the stomach and intestines, and the Morgagni hernia, which occurs on the right side and involves herniation of the liver and intestines. The surgical approach to repair these hernias may vary based on the size and location of the defect, and can include abdominal, thoracic, or a combined approach. During the procedure, a subcostal incision is generally made to access the abdominal cavity, allowing for examination of the abdominal viscera. The herniated contents are then reduced back into the abdominal cavity, and the hernia sac is excised. The diaphragm defect is repaired using sutures for smaller defects, while larger defects may require the use of a synthetic patch graft. In cases where the abdominal cavity is insufficient to accommodate the abdominal contents, a prosthetic patch may be placed over the contents, resulting in a ventral hernia that necessitates repair in a subsequent surgical procedure. Additionally, one or more chest tubes may be inserted at the end of the surgery to facilitate drainage and prevent complications.