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Coding/Billing Information

In document Cigna Medical Coverage Policy (Page 38-42)

Note: 1) This list of codes may not be all-inclusive.

2) Deleted codes and codes which are not effective at the time the service is rendered may not be eligible for reimbursement

Covered when medically necessary: CPT®*

Codes

43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)

43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption

43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) 43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie,

sleeve gastrectomy)

43842 Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty

43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty

43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)

43846 Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy

43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption

Experimental/Investigational/Unproven/Not Covered when used to report any procedure listed as not covered in this coverage policy:

CPT* Codes Description

43647 Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum

43659 Unlisted laparoscopy procedure, stomach

43881 Implantation or replacement of gastric neurostimulator electrodes, antrum, open 43999 Unlisted procedure, stomach

64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling

0312T Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction (EGJ), with implantation of pulse generator, includes programming

0313T Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or

replacement of vagal trunk neurostimulator electrode array, including connection to existing pulse generator

0316T Vagus nerve blocking therapy (morbid obesity); replacement of pulse generator 0317T Vagus nerve blocking therapy (morbid obesity); neurostmiulator pulse generator

electronic analysis, includes reprogramming when performed Silicone Gastric Banding Adjustment

Covered when medically necessary: HCPCS

Codes

Description

S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline

Reoperation and Repeat Bariatric Surgery Covered when medically necessary:

CPT®* Codes

43771 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only

43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only

43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only

43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components

43848 Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)

43850 Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy

43855 Revision of gastroduodenal anastomosis (gastroduodenostomy) with

reconstruction; with vagotomy

43860 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy

43865 Revision of gastrojejunal anastomosis (gastrojejunostomy) with

reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy

43887 Gastric restrictive procedure, open; removal of subcutaneous port component only

43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only

Bariatric Surgery for Type 2 Diabetes Mellitus

Experimental/Investigational/Unproven/Not Covered when performed solely for the treatment of type 2 diabetes mellitus when the BMI is < 35:

CPT®* Codes

Description

43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less)

43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption

43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components) 43771 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric

restrictive device component only

43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only

43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only

43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components

43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)

43842 Gastric restrictive procedure, without gastric bypass, for morbid obesity; Vertical-banded gastroplasty

43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty

43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)

43846 Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy

43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption

43848 Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)

43850 Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy

43855 Revision of gastroduodenal anastomosis (gastroduodenostomy) with

reconstruction; with vagotomy

43860 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy

43865 Revision of gastrojejunal anastomosis (gastrojejunostomy) with

reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy

43887 Gastric restrictive procedure, open; removal of subcutaneous port component only

43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only

HCPCS Codes

Description

S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline

Prophylactic Vena Cava Placement Covered when medically necessary:

CPT®* Codes

Description

37191 Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and

interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed

Other Procedures Performed in Conjunction with Bariatric Surgery

Not medically necessary/Not covered when performed in conjunction with a bariatric surgery in the absence of signs or symptoms of disease:

CPT®* Codes

Description

43234 Upper gastrointestinal endoscopy, simple primary examination (eg, with small diameter flexible endoscope) (separate procedure) (Code deleted 12/31/2013) 43332 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy,

except neonatal; without implantation of mesh or other prosthesis

43333 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis

43334 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis

43335 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis

43336 Repair, paraesophageal hiatal hernia, (including fundoplication), via

thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis

43337 Repair, paraesophageal hiatal hernia, (including fundoplication), via

prosthesis

47000 Biopsy of liver, needle; percutaneous

47001 Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure)

47562 Laparoscopy, surgical; cholecystectomy

47563 Laparoscopy, surgical; cholecystectomy with cholangiography

47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct 47600 Cholecystectomy;

47605 Cholecystectomy; with cholangiography

47610 Cholecystectomy with exploration of common duct;

*Current Procedural Terminology (CPT®) ©2013 American Medical Association: Chicago, IL.

In document Cigna Medical Coverage Policy (Page 38-42)

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