tci General Surgery Coding Alert - 2009 Issue 13

READER QUESTIONS: Reserve 43800 for Open Pyloroplasty

Question: My surgeon did a laparoscopic pyloroplasty. I don't see a code for this procedure. Should I use 43800? Oklahoma Subscriber Answer: You should not use 43800 (Pyloroplasty). That code is strictly for an open pyloroplasty. You are correct, however, that CPT offers no specific code for a laparoscopic pyloroplasty. Therefore, you need to use the unlisted procedure code: 43659(Unlisted laparoscopy procedure, stomach). Report the unlisted procedure code and in your documentation to the payer, compare the procedure to the work involved with 43800 unless the surgeon stated that there was a big difference in the work involved for...

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