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Thread: Revision Fee?

  1. #1

    Question Revision Fee?

    AAPC: Back to School
    Hello everyone,

    I work for a Bariatric center here in Dallas. We are one of the few practices that provides surgery to patients with a previously failed bariatric procedure. We charge a fee that is not billable to the insurance carriers to handle these special cases. We do have a signed waiver in the chart outlining what the fee is and what it's for. Are we compliant with payors by doing this and having the waiver documentation?

    My personal thought is to bill the insurance under unlisted code 99199, unlisted special procedure or report.

    If any one has any advise they can share I and my practice will greatly appreciate it.

  2. #2
    Join Date
    Apr 2007
    Oak Ridge


    We are multispecialty surgery practice in TN. We have a lot a baritarics we do. However, for the revision of the failed procedures, there is an open code 43848; unfortunatly our practice does this laparoscopically, and we generally use the unlisted code 43659. We have suffexs appended to ours since we do so many times of procedures that are unlisted.

    You may check with each carrier on thier specifics as to if you are compliant not billing to them; however, if it is a "cosmetic" or non-covered benefit, you cn bill the member and be compliant.

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