CPT® Code 39520

Deleted

The procedure described by CPT® Code 39520 refers to the surgical repair of a diaphragmatic hernia, specifically an esophageal hiatal hernia, using a transthoracic approach. An esophageal hiatal hernia occurs when the esophageal hiatus, the opening in the diaphragm through which the esophagus passes from the chest into the abdomen, becomes enlarged. This enlargement allows a portion of the upper stomach to protrude into the chest cavity, which can lead to various complications, including gastroesophageal reflux disease (GERD) and difficulty swallowing. The transthoracic approach is particularly indicated for patients who have previously undergone surgery for a diaphragmatic hernia or for those presenting with an irreducible hernia, which cannot be pushed back into the abdomen. During the procedure, a left posterolateral thoracotomy is performed to access the thoracic cavity, allowing the surgeon to mobilize the esophagus up to the aortic arch. The lower esophagus and the esophageal sphincter are then repositioned back into the abdominal cavity. A fundoplication is performed, where the fundus of the stomach is sutured around the esophagus at the gastroesophageal junction, which helps to prevent reflux. Finally, the defect in the diaphragm is repaired, and the chest is closed, with a chest tube placed if necessary to facilitate drainage and prevent complications.