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Lap Gastric resection and open Gastric Resection

  1. Default Lap Gastric resection and open Gastric Resection
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    Hello,
    Can someone help with coding a Lap Gastric Resection for a Proximal stomach mass and possible open gastric Resection for proximal stomach mass?

    The physician states he beleives 43633 is the best code to use. ( The surgery has not yet been performed yet, it is being scheduled) He asked what I think?

    I am not really sure, but I beleive, the lap gastric resection may be a unlisted 43659?, and the open gastric resection 43633? ( but for the open PX, it says DISTAL with gastroduodenostomy, I don't see one for proximal.

    The best dx I found for distal and proximal mass is 537.9 ( dz of stomach unspecified), and I don't believe this dx is covered. ( according to the coding companion)

    Please let me know your thoughts on both the procedures and the dx code. Thanks!

  2. #2
    Location
    Indianapolis
    Posts
    30
    Thumbs up
    Yes you are correct for both. Our office uses the same.

  3. Default reply
    Thank you!

  4. Default One more thing
    Is there a specific price that I should submit with the unlisted code, or will the insurance company figure that out? Thanks!

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