Wiki lap band adjustment in the office

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kcadieux

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Hello,

I have a doctor's office that does lap band adjustments in the office outside the global period. We have been using the s2083, but suddenly we are getting denials for billed incorrectly or another code should be used. Has anyone ran into this or are you using a different code??

Please help, we are pulling our hair out :confused:

Karen
 
We have been using 43999 with the explanation of Lap Band Adjustment. We have also used the S2083. It just depends on the carrier.

If I am reading 96379 correctly, this CPT code applies for intravenous and intra-arterial injections. Lap bands are adjusted thru a port.

Hope this helps.....
 
lap band

:confused:
I agree with Sandy.
I`m still using 90772 and S2083 for statistics.
thanx,
Dense M
 
...

We use the S-code for most carriers (S2083) and 43999 for Medicare with an additional field of "lap band adjustment". I agree, I don't think therapeutic injection codes are correct either.

I think it's fair to note we have one local insurance (HMO) whose policy is to use an E/M for the adjustment. Given our provider's documentation and the limited focus of the visit, we end up coding a 99212 more often than not with an occasional 99213.

The desparity between reimbursement between an E/M and the reimbursement we're getting for the S2083 is huge, but we're stuck since there's not a more specific regular CPT.
 
gastric band fill (adjustment) in the office

We are not getting paid from medicare with code 43999 - even with the description info and appropriate dx's etc... When I spoke with a senior medicare rep, I was told to include a cost ($) in box 19 along with the decription.
Does anyone do this?

Thanks-
 
Lap band adjustment

I'm not sure what part of the country any of you are in, but I found a Medicare Provider Education article from our New England carrier (Internet-Only Manual, Pub. 100-03, NCD 100.1 See also Pub. 100-04, Chapter 32, section 150.) I'm sorry, but it won't let me attach it. It states that 43999 is the correct code to use for lap band adjustment. There is also an article in the letters to the editor section of the July Coding Edge that says the same.
 
We also use the S2083 in our office. Does anyone charge an office visit with modifier 25 if the patient was scheduled for a follow-up visit and the doctor decides to fill?
 
Lap Band Adjustments

We also use the S2083 for most carriers. Medicare being the exception. We use office calls for them, level depending on the documentation. I only use and office call with mod 25 if the patient and doctor discussed something other than the band adjustment. This also depends on the amount of documentation for the other problem.
 
Lap band adjustment in the office

Just curious...Are these adjustments billed outside the global period for the surgery? Do most carriers pay for the adjustments? It seems like such a minor procedure that if an E/M code is billed at the same time, the adjustment wouldn't be covered separately.
 
96522

This code is for intravenous or intra-arterial and is used for therapeuic or chemo drugs. Would not use this code for UGI Adjustments

Amy, CCP CPC CMBS
 
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