# Gastric Band Adjustment



## CarolinaSunshine (Mar 15, 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.


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## MCook (Mar 16, 2013)

We always sequence V53.51 first as that is the reason for the visit when they are getting a fill or deflate.  There is no indication that this cannot be used as a primary dx.  The only exlcusion is for inpatient's but ours occur on an outpatient basis.  We also track their weight loss and select the appropriate BMI/obesity code for that day.  

Examples:
V53.51, 278.01, V85.41
V53.51, 278.00, V85.35
V53.51, 278.02, V85.22
Once they reach a healthy weight (BMI <24.9) we report V53.51, V85.1

When they return for their yearly follow-up visits and no fill/deflate occurs, we report V45.86.  I use the website below to quickly determine the patients BMI:
http://nhlbisupport.com/bmi/


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## dollyfader (Mar 16, 2013)

*Gastric band adjustment*

S2083  - we seem to have success in just coding  278.01. If the patient comes in for gerd, we still put in 278.01 and 530.81 or other symptom as 787.03 and still gets paid as long as their plan covers the fill.

Dolly
cpc cpc h ccsp


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## cldavenport (Mar 18, 2013)

In the Cutting Edge, March 2013, pg 14, there is a small article about Gastric Band Adjustments. It doesn't have too much detail about dx , but just for the extra "tidbit" of info about this topic.

Thanks


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