Question:
Insurance Codes for DS

Can someone please tell me what the codes are for the DS surgery? Thanks!    — drjakata (posted on October 22, 2004)

October 22, 2004
CPT Codes<P> 43846 Short limb RNY<P> 43847 Long limb RNY<P> 43659 Laparoscopic<P> 43847 Duodenal Switch<P> 47600 Duodenal Switch Related<P> 43633 Duodenal Switch Related<P> This is from the OH site (http://www.obesityhelp.com/morbidobesity/m-ins-insurer.phtml) The one I have seen used is 43847 -- but I have also heard that some DS surgeons have used "creative coding" to avoid causing the insurance company from denying it.<P> Note also that Wellmark BC/BS says that the proper code is something else entirely (a "miscellaneous procedure" code), i.e., 43999, which is the same code they use for a distal RNY, while saying that the 43847 code is for the BPD or Scopinaro procedure, which absolutely is a different operation!<P> http://www.wellmark.com/e_business/provider/medical_policies/policies/obesity_surgery.htm # Biliopancreatic Bypass procedure (Scopinaro) - use the CPT code 43847<P> # Biliopancreatic Bypass with duodenal switch - use the CPT code 43999<P> # Long Limb Gastric Bypass (>100cm)- use the CPT code 43999<P> Note that it is VERY important that the diagnosis code or ICD-9 code MUST BE 278.01 (the code for MORBID Obesity, to be distinguished from 278.00, which is simple obesity)!<P>
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