Wiki Diagnosis for 43774

[mconnolly]

We are having trouble getting paid by bcbs for the gastric band removal (43774), for medical necessity. We have tried 2 different complication codes but they still won't pay. Medicare pays the t85.598a code but need an appropriate dx for bcbs. Can anyone tell me what they use and are you getting paid.

Thanks.

 

[michellepilcher]

What is the medical necessity the provider is charting?

 

[lindacoder]

I would try K95.01 or K95.09 and then if there is dysphagia or vomiting or whatever use that as a secondary code.