tci General Surgery Coding Alert - 2010 Issue 2

READER QUESTIONS: Report Perforation Repair During Global

Question: My surgeon performed a laparoscopic gastric sleeve procedure. Three days later, he performed an exploratory laparotomy with closure of gastric perforation due to a staple line leak. How should I code the procedures for the first and second day? Minnesota Subscriber Answer: Report the laparoscopic gastric sleeve procedure as 43775 (Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy [i.e., sleeve gastrectomy]). The appropriate code for the perforation closure is 43840 (Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury). Because the surgeon performs the gastric wound suture during the 90-day global period for the gastric sleeve...

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