Health Information Management

Q&A: Coding for gastric lap band erosion with infection

HIM Connection, February 23, 2010

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Q: How should I code gastric lap band erosion with infection? The ICD-9-CM Manual instructs coders to report code 997.4 (complications of bariatric surgery). However, I think this code is only for complications that are organic in nature (i.e., obstructions). When a gastric band migrates, should we consider this a mechanical complication? If so, should I report code 996.59 (mechanical complication of other specified prosthetic device, implant, and graft not elsewhere classified)? American Hospital Association representatives acknowledge that a code doesn’t exist for this complication.
 
A: Report code 997.4 (complications of gastrointestinal tract) as the ICD-9-CM Manual instructs. Code 996.xx (complications peculiar to certain specified procedures) excludes 997.4. To find code 997.4, look in the alphabetic index under “Complications, stomach banding,” which will lead you to code 997.4. In the tabular list, 996.xx excludes 997.4.
 
Editor’s note: Paula Archer, managing consultant at BKD, LLP, in Little Rock, AR, answered this question in the February issue of Briefings on Coding Compliance Strategies.



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