Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot
CPT®
39530

CPT® Code 39530
Deleted

Code deleted, to report see 43336, 43337

Official Description

Repair, diaphragmatic hernia (esophageal hiatal); combined, thoracoabdominal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 39530 involves the surgical repair of a diaphragmatic hernia, specifically an esophageal hiatal hernia, utilizing a combined thoracoabdominal approach. This type of 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. The combined thoracoabdominal approach is particularly indicated for patients who have previously undergone diaphragmatic hernia surgery or for those presenting with an irreducible hernia, which cannot be pushed back into the abdomen. The surgical technique involves both a left posterolateral thoracotomy, which provides access to the esophagus, and an upper abdominal incision, which allows for direct access to the diaphragm and stomach. This dual approach facilitates simultaneous dissection in both the upper abdomen and left chest, enabling the surgeon to effectively excise the hernia sac and address any associated anatomical issues. The procedure is comprehensive, addressing not only the hernia itself but also any potential complications such as strictures at the esophagogastric junction, ensuring a thorough and effective repair.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for the following conditions:

  • Diaphragmatic Hernia The presence of an esophageal hiatal hernia, where the upper stomach herniates through the enlarged esophageal hiatus into the chest cavity.
  • Previous Surgery Patients who have a history of prior diaphragmatic hernia repair surgery may require this approach due to complications or recurrence.
  • Irreducible Hernia Cases where the hernia cannot be manually reduced back into the abdominal cavity, necessitating surgical intervention.

2. Procedure

The surgical procedure for CPT® Code 39530 involves several critical steps to ensure effective repair of the esophageal hiatal hernia:

  • Step 1: Incision The surgeon begins by making a left posterolateral thoracotomy incision to access the esophagus. Simultaneously, an upper abdominal incision is created to expose the diaphragm and stomach, allowing for comprehensive access to the affected areas.
  • Step 2: Dissection Once the incisions are made, the surgeon performs simultaneous dissection in both the upper abdomen and left chest. This step is crucial for identifying and dividing any adhesions that may be present, which can complicate the surgical field.
  • Step 3: Hernia Sac Excision The hernia sac is carefully excised to remove the protruding stomach tissue from the thoracic cavity. This step is essential to alleviate any pressure on the surrounding structures and restore normal anatomy.
  • Step 4: Identification of Anatomical Structures The muscular origins (crura) of the diaphragm and the esophageal hiatus are identified. If the patient has previously undergone a fundoplication, this is taken down to facilitate the repair.
  • Step 5: Esophagogastric Junction Assessment The anatomic esophagogastric junction is located, and the lower esophagus along with the esophageal sphincter is returned to the abdominal cavity. This step is vital for restoring normal function.
  • Step 6: Stricture Management If a stricture is present at the esophagogastric junction, a bougie is introduced into the esophagus and guided across the junction to dilate the stricture, ensuring that the passage is adequately widened.
  • Step 7: Gastroplasty (if necessary) If the esophagogastric junction does not remain below the diaphragmatic hiatus after dilation, a gastroplasty is performed. This involves holding the bougie in place against the lesser curvature of the stomach and creating a gastric tube (neoesophagus) using the stomach wall.
  • Step 8: Fundoplication The fundus of the stomach is then sutured around the esophagus at the gastroesophageal junction, either partially or completely, to prevent future reflux.
  • Step 9: Diaphragm Closure Finally, the muscular origins (crura) of the diaphragm are approximated to create an esophageal hiatus of normal size, completing the repair and restoring the anatomical integrity of the diaphragm.

3. Post-Procedure

Post-procedure care following the repair of an esophageal hiatal hernia using CPT® Code 39530 typically involves monitoring for complications such as infection, bleeding, or recurrence of the hernia. Patients may require a period of hospitalization for observation and management of pain. Dietary modifications may be necessary, and patients are often advised to start with a liquid diet before gradually reintroducing solid foods. Follow-up appointments are essential to assess recovery and ensure that the esophagogastric junction is functioning properly. Any signs of complications, such as difficulty swallowing or persistent reflux, should be promptly addressed by the healthcare provider.
Short Descr REPAIR OF DIAPHRAGM HERNIA
Medium Descr RPR DIPHRG HRNA CMBN THORACOABDL
Long Descr Repair, diaphragmatic hernia (esophageal hiatal); combined, thoracoabdominal
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 86 - Other hernia repair
Date
Action
Notes
2011-01-01 Deleted Code deleted, to report see 43336, 43337
Pre-1990 Added Code added.
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"