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Tip: Handle bariatric surgery coding

Ambulatory Surgery Reimbursement Update, October 28, 2008

While Medicare covers some bariatric procedures in ASCs, it does not cover most of them. Medicare does not cover CPT codes 43770, 43771, 43772, 43773, 43774, 43848, and S2083 for ASCs. However, Medicare will reimburse ASCs for codes 43886, 43887, and 43888.

Laparoscopic bariatric procedures include:

• 43770—Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (for example, gastric band and subcutaneous port components)
• 43771—Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only
• 43772—Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only
• 43773—Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only
• 43774—Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components

Open bariatric procedures include:

• 43848—Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)
• 43886—Gastric restrictive procedure, open; revision of subcutaneous port component only
• 43887—Gastric restrictive procedure, open; removal of subcutaneous port component only
• 43888—Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only

Report an injection adjustment procedure with HCPCS code S2083 (adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline). If the payer will not accept a HCPCS code, use the unlisted CPT code 43999.

This tip is brought to you by Ellis Medical Consulting, Inc.

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