General Surgery Coding Alert

Question: We have a surgical report that describes a laparoscopic procedure in which the surgeon places a lap band and access port to inflate the band at a later time. Can we report these as two separate procedures?

Arkansas Subscriber

Answer: No, you should not separately report the band and port placement for the gastric banding procedure you describe. Instead, you should list one unit of 43770 (Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device [e.g., gastric band and subcutaneous port components]) to describe the service. 

How it works: During a gastric banding procedure, the surgeon places an adjustable silicone band, typically just below the gastroesophageal junction. The surgeon also places an access port connected to the band, through which the physician may inject (or aspirate) saline to expand (or contract) the band and effectively manipulate stomach size. Filling and adjusting the band typically takes place at a follow-up appointment after the patient has recovered from surgery.

Because the surgery requires the physician to place both the adjustable band and subcutaneous port, and because the patient may require revision/removal/replacement of some parts following the initial surgery, CPT® includes several codes to capture those services. Although 43770 describes placement of both the band and port in a single session, you can report placement of either of those components alone using 43773 (…removal and replacement of adjustable gastric restrictive device component only).