# Gastric Band Adjustment Diagnosis Coding



## CarolinaSunshine (Mar 13, 2013)

What diagnosis code(s) would be used for Gastric Band Adjustments (S2083 & 43999)?  We are looking at whether or not the V53.51 should/should not be listed as the primary dx.  There are ICD9 2013 Guidelines for Coding and Reporting on page 25 of the ICD-9 book titled "V Codes that may only be principle/first-listed diagnosis".  V53.51 and V45.86 are not on this list that meet the definition of principle or first listed diagnosis.
Also, in looking at page 23--7) Aftercare codes it states that these aftercare codes "cover situations when the initial treatment of a disease or injury has been performed and the patient requires continued care during the healing or recovery. The aftercare V code should not be used if treatment is directed at a current, acute disease or injury. The diagnosis code is to be used in these cases."  
The following coding has been discussed in our office:
V53.51, V45.86 or 278.01, V53.51, V45.86 or V53.51, 278.01
These adjustments could be done for years after the patient has surgery so I'm not sure how long to use the 278.01 morbid obesity code if the patient is no longer obese.
TIA for any help in sequencing dx codes.
Denise


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## Lynda Wetter (Mar 19, 2013)

V45.86?


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## Kisalyn (Mar 19, 2013)

V53.51 looks good.

I read the princple dx rule to mean that if there isn't a symbol (PDx) denoting the code as a princple dx only, then you are allowed to use it in any sequence as appropriate. Since V53.51 doesn't have that symbol next to it, then you can list it first.


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## Chronicles Billing (May 7, 2013)

*Lap Band Adjustment*

Hello everyone!
When I bill for lap band adjustments there are a couple requirements for commercial payers v/s Government payers.

V45.86
278.01
V53.51

Also, if the provider is also addressing a Co Morbidity then add that Dx code and append -25 to the E&M code.


Instead of S2083 Medicare requires 43999 with "Lap bad adjustment"  on Line 19 of the CMS1500. don't forget to bill for the admin

Genieve Nottage


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