tci General Surgery Coding Alert - 2022 Issue Q1

Reader Questions: Document Medical Necessity for Appendectomy

Question: Our surgeon performed a Roux-en-Y bariatric surgery procedure. During the procedure the surgeon noted an inflamed appendix with scarring and also performed an appendectomy. How should we code this? Utah Subscriber Answer: You don’t mention if the procedure is open or laparoscopic. Assuming this is an open procedure, report the Roux-en-Y as 43846 (Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy). If the short limb is greater than 150 cm, you should instead report 43847 (… with small intestine reconstruction to limit absorption). Because the surgeon notes...

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