Surgery Codes

[FloridaJen]

As I try to navigate my appeal, I was looking at different codes. Can anyone explain these codes to me?
My surgeon submitted this: "In this case, there is no listing for CPT for Lap DS. Therefore, the unlisted code 43659 is used. This should be pre-authorized and charged equal to 43845 (Open DS) which the most comparable code for that procedure."

but I'm wondering how this works and if a more generic bariatric code can be used?

https://www.icd10data.com/ICD10CM/Codes/Z00-Z99/Z77-Z99/Z98-/Z98.0
https://www.icd10data.com/ICD10CM/Codes/Z00-Z99/Z77-Z99/Z98-/Z98.84


DianaCox Larra

 

[southernlady]

That’s the correct code for the DS.

 

[FloridaJen]

That’s the correct code for the DS.

I updated it, I had it wrong...

 

[DianaCox]

In this case in particular, you DON’T want a more generic code - part of your appeal argument is that the DS is not equivalent to your prior bariatric surgery.