# Fluoroscopy with lapband adjustment



## TWinsor (Oct 23, 2013)

Can anyone tell me if it is correct to bill the 74246 for fluoroscopy during lapband adjustment.  Documentation is as follows;

Under fluoroscopy guidance port was accessed with Huber needle (77002?) volume of saline was checked.  Lapband was then filled with slight excess of sterile saline.  Patient stood up within the C-arm fluoroscope and drank thin barium slowly.  Viedeo fluoroscopy was performed for duration of swallow. barium was obstructed by overfilled lapband and saline was slowly withdrawn fromo band until barium was seen to empty through lapband. the ability to swallow was further tested with at least 2 swallows.  Satisfied with tightness, patient lay down and needle was withdrawn.

I am not sure if this is sufficient or appropriate to bill the 74246 in addition to the 77002 and the S2083 or 43999.

Thanks in advance for any help!!


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## sheardmd (Oct 23, 2013)

We only bill the S2083 or 43999 for Medicare and the 77002 for our fills under fluoro.


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## TWinsor (Oct 24, 2013)

Thank you Melissa.

The physician is still in disagreement.  Do you have any documentation to support not billing the 74246 in these cases?

Thanks again,
Terri


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## sheardmd (Oct 24, 2013)

I used to have a General Surgery or GI Coding Alert article about this but I can't seem to locate it.  I will keep looking and let you know if I find it.


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