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Thread: lap band adjustment in the office

  1. #11

    Question gastric band fill (adjustment) in the office

    AAPC: Back to School
    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?


  2. #12

    Exclamation 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.

  3. #13


    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?

  4. #14
    Join Date
    Apr 2007

    Default 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.

  5. #15
    Join Date
    Apr 2007

    Question 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.

  6. #16


    Does anyone have an anwer to the last question yet?

  7. #17


    96372 is incorrect

  8. #18
    Join Date
    Apr 2007


    We use the s2083 for most carriers and 43999 with notes in box 19 for medicare. What are some thoughts on 96522?

  9. #19

    Default 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


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