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Gastric Band adjust post-op

S

Shirley

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Is there a way to get a gastric band adjust reimbursed after post-op period with Medicare??? What codes should be used (ICD-9/CPT)?
Thanks much!
SHIRLEY
 
The way I get them paid through WPS is use unlisted code 43999 and amount for adjustment (you do not need a modifier on it - they will request records for the adjustment). They have a 10 day global for adjustments. If patients are seen within 90 days of an adjustment but do not have an adjustment then a 24 modifier can be utilized for the office visit and they will then pay. Hope this helps as it took an act of Congress to finally get someone from WPS to get it worked out. ;)
 
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