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Wiki Gastric Band converted to Gastrectomy Laparscopic

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cjrottum

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I keep running into patient's who have had a slipped gastric band and are converting to gastrectomy. The patient's are not morbidly obese anymore, some are even completely normal BMI but have gained a bit since their band failure. The coding for this would be 43774 and 43775 but we have had denials on 43775 due to the absence of 278.01. Has anyone else run into this issue? If so, what are you doing? I have read that using 43659 alone with a description of "gastric band converted to gastrectomy" and then then price for both procedures entered manually will work. Is this appropriate though?
Help needed for a new bariatric surgery coder!!:confused:
Thanks,
Corrina Rottum, RHIT, CGIC
 
That is a second weight loss surgery. Wouldn't patient need to follow original surgery guidelines to move forward? What is the denial reason?
 
They are denying because the pt is no longer obese so I cannot use the 278 codes. I am using the complication of gastric resrictive procedure code, the manifestation (in this case dysphagia) on them.
 
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