Wiki Coding for a Two part bariatric surgery??

[buppkl]

We have a Medicare HMO pt that the Dr. is planning to do a Gastric Bypass on for morbid obesity. Due to the patient's risk factors, the doc is planning on doing the RYGB in two parts. First is a lap sleeve gastrectomy and once the patient loses a specified amount of weight, the second part of the procedure - the bypass, will be completed. How would you code for the procedures. 43644 is the total procedure but if done in stages Medicare will not cover the sleeve if performed alone as 43775. How would you submit this case? Any help appreciated.

 

[mjewett]

I've heard of doctors doing code 43845 in two steps this one includes the partial gastrectomy, and biliopancreatic diversion with duodenal switch. (also called BPD) Which is covered by Medicare.

Also code 43644 doesn't include sleeve gastrectomy. The stomach is not excised in the Roux-en Y surgery.

Maybe I'm misunderstanding the procedures being done, but if not maybe clarify with your surgeon.