Anesthesia Coding Alert

Reader Question:

Roux-en-Y Anesthesia

Question: I know that 00797 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; for gastric restrictive procedure for morbid obesity) is the correct anesthesia code for 43846 (Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb [less than 100 cm] Roux-en-Y gastroenterostomy), but I'm having trouble with reimbursement for it. What advice do you have on the correct code to use and appropriate reimbursement rates? South Carolina Subscriber Answer: Gastric restrictive procedures have been on the rise the past few years; the addition of 00797 to CPT is a big step for physicians and should simplify reimbursement for the procedure. Carriers are frequently slow to adopt new codes, so your problem may be that the carrier has not loaded the 2002 codes into its computer. You may also need to clarify whether the carrier covers the procedure and whether it was authorized. You can try billing with the surgical CPT code (43846) instead of the anesthesia code, and verify that the surgeon obtained authorization for the procedure.  
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Anesthesia Coding Alert

View All