# 43770, 43281.59



## 0913@70 (Feb 22, 2012)

If surgeon did laprascopic application of adjustable gastric band and haital hernia reapair, is this correct coding; 43770 and 43281.59 or 43770 and 43281.51?

Thank you


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## srinivas r sajja (Feb 22, 2012)

A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm. The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. Lap. hiatal hernia is coded using 43281, whereas lap gastric banding by 43770. Gastric banding is done for morbidly obese patients and it's a bariatric surgery. But you need to add modifier 52 to the CPT 43770 when only one component (either of the gastric band and subcutaneous port components) are placed. As per CCI edits, there's no bundling between these two codes. So you could bill these two together. But remember to provide supporting documentation along with the claim, specially documentation to prove the medical necessity of lap. gastric procedure. 
from supercoder.


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## 0913@70 (Feb 23, 2012)

Thank you so much on detailed explanation. This helps a lot.


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## 0913@70 (Feb 23, 2012)

I am sorry, it is me again,

I checked the reprot. Can you trell me the verbage I should look for in the operative reprot in order to know as how many components were place. 
The op report I am looking states;
"AP standard Lap-Band was then flushed and prepeared. It was passed through the 15 mm port. The band tubing was then passed to the retrogastric grasperand though tunnel. the band was pulled into position. The tubing was passed on through the buckle of the band and it was close".

Is this one component or two?
How many components are there, can you please list them all?

Thank you so much


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## srinivas r sajja (Feb 23, 2012)

gastric band and subcutaneous port  are the two components. ur description doesn't talk about subcutatneous port placement. I'll go with one component only.


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## 0913@70 (Feb 24, 2012)

Thank you so much!


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