General Surgery Coding Alert

Question: Our surgeon operated on a patient who experienced significant weight loss after undergoing bariatric surgery. The patient experienced persistent skin irritations, lesions, and infections caused by friction in the folds of their excess skin. The surgery involved removing skin and fat, performing intermediate and complex closure and plication of the facia to relieve tension, plus repositioning the umbilicus. How should we code this?

Wyoming Subscriber

Answer: The procedure you describe is a panniculectomy, which is surgery to remove excess, loose abdominal skin and fat that may occur following extensive weight loss. The proper code for this procedure is 15830 (Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy).

Because the surgeon also performed fascial plication and repositioning the umbilicus, you should add code +15847 (Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for primary procedure)).

Take note: Even though you describe specific steps such as intermediate and complex closure or adjacent tissue transfer for the umbilicus repositioning, you should not report additional codes for those steps. The 15830 and +15847 codes encompass those individual steps.