Wiki Help with Pyloromyotomy

boyced@email.chop.edu

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Recently my doctors have started doing Pyloromyotomy's laparoscopically. But I can not find a code that says laparoscopic approach.
Someone told me that the 43520 is still ok b/c the approach is just laparoscopic...but I'd like to see your opinions...
Any advice would be great!
 
Laparoscopic Pyloromyotomy

I code for Pediatric Surgeons, using the unlisted cpt 43659 for the Laparoscopic Pyloromyotomy...unless the insurance is BCBS.
 
So what code do you use for BCBS?

I code for Pediatric Surgeons, using the unlisted cpt 43659 for the Laparoscopic Pyloromyotomy...unless the insurance is BCBS.

So what code do you use for BCBS?

We use the unlisted code for all - regardless of insurance.

BUT ... we've noticed that many insurance companies have started including CPT 43659 as a "bariatric" procedure which requires special pre-authorization. Since the laparoscipic pyloromyotomy is usually done on an emergency basis, we have our staff contacting insurance immediately the next morning for authorization, using the unlisted code and copy of medical records.

We're getting paid.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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