bariatric surgery - my surgeon is doing a lot of laparoscopy

CINDYMALONE

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my surgeon is doing a lot of laparoscopy revisions of gastric bypasses and the only code i am able to see if maybe correct is 43659 unlisted code for the stomach. he always wants to use the open revision code 43848. i am confused on this. please help.
 

cmartin

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Yes, 43659 for laparoscopic revision. However, I did learn that in many cases it was being scheduled as a "revision" if the patient had had any prior bari surgery, but often the op notes didn't bear out a revision - it was more like the new procedure was made more difficult by the prior surgery due to adhesions & such, but was basically "just" a lap roux-Y GBP or whatever. More properly coded as 43644, or 43644-22. While there was some thought that insurances were more likely to cover a revision, this isn't really the case - and for a revision they want complications w/the 1st op other than just not working. They seem just as likely to cover a 2nd bari surgery if their necessity requirements are met, but it's important than everyone is on the same page & clear about which of these circumstances applies.
 
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