AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 2; Ask the Editor
Reversal of Roux-En-Y Bypass
A patient presented for reversal of a Roux-en-Y gastric bypass. Trocars were placed, the roux limb was identified and traced up to the gastric pouch and dissected off the omentum on either side of the excluded stomach posteriorly. Via laparoscopy, the gastric pouch was dissected above the gastrojejunostomy and the roux limb was dissected down and out of the field. At this point, the gastric pouch would reach nicely to the excluded stomach in the natural anatomic position. The anastomosis was then checked for leaks via endoscopy. Attention was then turned to the pylorus for the pyloromyotomy. The pylorus was transected from the stomach down into the duodenum, pulled transversely and reclosed. Next, the G-tube was placed into the stomach through the anterior abdominal wall. The Roux limb was then dissected down off the transverse colon and a complete reversal of the small bowel portion of the anastomosis was completed. Approximately 30 cm of the end of the Roux limb had to be resected due to devascularization. The new end of the Roux limb was anastomosed with the biliary limb creating two jejunostomies. What are the procedure codes for reversal of a Roux-en-Y? ...
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Article Overview
This premium article discusses operative reversal of a Roux-en-Y gastric bypass and associated laparoscopic reconstruction steps. It is relevant for surgical coders, bariatric surgery practices, and revenue cycle teams that need to understand how the procedure is documented and how the operative components are described in coding references. The article focuses on the overall surgical approach, intraoperative evaluation, and related anatomy handled during reversal.
Why This Topic Matters
Bariatric revision and reversal cases are documentation-sensitive and often require careful interpretation of the operative report. Understanding the procedure scope helps coders and auditors assess the service documented in the surgical record.
What You Will Learn
- How the article frames Roux-en-Y bypass reversal as a laparoscopic operative case.
- What general reconstructive and intraoperative components are discussed in the surgical narrative.
- How the procedure is presented from a documentation and coding-relevance perspective.
- Questions answered
Who Should Read This
- Medical coders
- Bariatric surgery coders
- Surgical auditors
- Revenue cycle staff
- Clinical documentation specialists
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