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CPT 43831: Infant Gastrostomy Placement for Enteral Feeding
CPT code 43831 represents surgical creation of direct gastric access for infants who need enteral feeding. Nationally, this procedure is clinically significant because it establishes a reliable route for nutrition in neonates and young infants with feeding impairment, congenital anomalies, or other conditions that prevent safe oral intake. The code is relevant to hospitals and ambulatory surgical centers that provide pediatric surgical and nutrition services.
Key payers in the scope of this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, common sites of service, and the types of benchmarks and policy elements typically associated with this code. The publication highlights how payers handle coverage considerations, typical billing scenarios, and where reviewers commonly focus their clinical documentation and coding validation.
This summary is intended to orient clinicians, coders, and policy analysts to the primary purpose of CPT code 43831, the typical care settings, and the payer environment. Data not available in the input will be noted where relevant in the full publication.
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Billing Code Overview
CPT code 43831 describes a procedure in which the provider creates direct access to the lumen of the stomach for infants who require enteral feeding directly into the stomach. This procedure establishes a permanent or long-term gastric access route to facilitate nutrition delivery for babies who cannot feed orally.
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Service type: Surgical placement of gastrostomy access for enteral feeding
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Typical site of service: Hospital operating room or ambulatory surgical center, with postoperative care in inpatient or observation settings depending on clinical need