General Surgery Coding Alert

Question:  How should I code a Roux-en-Y gastrojejunostomy that the surgeon performed to treat a gastric outlet obstruction? The patient is not obese. 

Florida Subscriber

Answer:  You should use the procedure code that most closely describes the procedure documented in the operative report. From your brief description of a Roux-en-Y gastrojejunostomy, it appears that the correct code is 43633 (Gastrectomy, partial, distal; with Roux-en-Y reconstruction), although you don’t give enough detail to assign a code with any certainty.

Although 43633 describes a gastric bypass procedure that is sometimes used to treat morbid obesity, the procedure is not limited to that purpose. Your patient’s weight status is not relevant to the code selection. The gastric obstruction should demonstrate medical necessity for the procedure.