General Surgery Coding Alert

Question:Our lap-band rep told us not to bill morbid obesity as the diagnosis when a patient returns for a follow up visit outside the global period. Should we bill a co-morbid condition instead, as the rep suggested?Michigan SubscriberAnswer: The diagnosis code(s) you assign for an encounter should always reflect the information in the note. If the note says the patient is being followed for morbid obesity (278.01, Morbid obesity) that is the diagnosis code you should use, no matter who suggests otherwise.That said, depending on the documentation for the actual reason your surgeon is seeing the patient, you might use a different diagnosis code. For instance, the physician may be addressing some kind of nutritional deficiency post lap-band, and you should report the appropriate diagnosis code, such as 269.9 (Unspecified nutritional deficiency).You should also contact your major payers to see what they have to say about follow up visits outside [...]