I have a provider who has on several occasions found he has to perform another procedure while also performing the procedure he went in to perform.


My procedure has performed CPT 43770- Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components). While performing this procedure he stumbled across a hiatal hernia that needed to be repaired and performed the repair of the hiatal hernia (laparascopically).

Would it be appropriate to bill 43281 or 43282 (depending on if mesh is used) with 43770? These codes do not bundle but the stumbled across procedure has higher RVU's. I know usually you would bill in RVU order, but would that apply in this case?

Any help is greatly appreciated!