# Lap gastric bypass revision



## amny1212@yahoo.com (Aug 29, 2012)

Hello Everyone,needing some help.I've recently aquired two bariatric Surgeons (yappee!)

OPERATION: LAPARASCOPIC GASTRIC BYPASS BY REVISING THE GASTROJEJUNOSTOMY ANASTOMOSIS

PROCEDURE: THE ANTERIOR ABD WALL WAS PREPPED AND DRAPED IN THE USUAL FASHION.TROCARS WERE PLACED IN THE USUAL FASHION INCLUDING A 5MM OPIVIEW TO THE LEFT OF THE UMBILICUS.THIS WAS INFLATED.THE SCOPE WAS REINSERTED.THERE WAS NO EVIDENCE OF VISCERAL OR VASCULAR INJURY.

ADDITIONAL PORTS WERE THEN PLACED.ADHESIONS WERE TAKEN DOWN OFF THE ANTERIOR WALL.THE LIVER RETRACTOR WAS INSERTED AND ADHESIONS OF THE ROUX LIMB AND THE POUCH AND THE LIVER WERE TAKEN DOWN OFF THE GASTROESOPHAGEAL UNTIL THE GE JUNCTIONN COULD BE SEEN.A BOUGIE WAS PLACED THROUGHT THE ANASTOMOSIS AND ONCE THE ENTIRE ROUX LIMB AND POUCH THEN FREEF FROM THE SURROUNDING STRUCTURES USING ENDOGIA STAPLER WITH PURPLE LOAD,EXTRA TISSUE OF THE ROUX LIMB ON THE CANDY-CANE PORTION OF THE ROUX LIMB AND THE GASTRO-J AND THE PORTION OF THE POUCH WERE TAKEN OFF.

THE ENTIRE SUTURE LINE WAS OVERSEWN.PATIENT TOLERATED PROCEDURE WELL.THE BOUGIE WAS REMOVED.THE SPECIMEN WAS REMOVED.STERI STRIPS WERE APPLIED.

Now this is a "revision of a gastric bypass" done laparascopically , the code i've found that best fits (43850) I assume but that of course is an open code.Im I to code unlisted 43659 because there isnt a code to support this? not completely sure.

I would truely value anyones prespective!
thank you.


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