Question:
I need a revision and was wondering if there was special coding for it.

I have read on the site aobut it being coded as a repair verses a revision and that the insurance companies will pay for a repair. I spoke with my doctor and he said he didn't know of it being coded different. Those of you that have had revisions what did it take or was there any difficulty getting it approved. My BMI is 40, I haven't had any real weight loss in over a year. UGI shows my bottom stoma is blown out. So my pouch is useless.    — Carla T. (posted on July 20, 2003)

July 20, 2003
There are seperate CPT codes for a revision. Your doctors office should have a CPT coding manual. In the same section of what they use for RNY and such is in that area. I work for a surgeon who does RNY and he has done a few revisions. Some insurance companies will cover it, others say NO WAY. It just depends. Good luck! Hope this helps!
   — Ashley S.

July 20, 2003
43848- Revision of gastric restrictive procedure for morbid obesity (includes open revision of RNY). The code is the same for revision/repair, unless the repair encompasses procedures that aren't typically involved with the original procedure, in which case you would still have your 43848 but an additional code for whatever else was done. Hope that helps (Im a coder, promise I didn't pull that out of thin air :).
   — M. Me

July 21, 2003
Is your surgeon planning on fixing it? and what is he planning on doing to correct it?
   — star .

July 21, 2003
My doctor wants to fix it and change me from a proximal to a distal. I am curious because I have been reading back on previous postings on this subject and one stated that if the coding is for a repair verses just a revision it is approved easier. I don't know if this is correct but I am asking to see if anyone has more info.
   — Carla T.

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