Radiology Coders - Tighten Up Your Lap Band Coding

By Author: Nancy Rose
Total Articles: 53
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If your radiologist carries out adjustments during the surgery's global period, do this.




Question: Our radiologist carries out percutaneous LAP-BAND adjustments. We go for S2083 for the service and 77002 for the fluoroscopy. Is this the right fluoroscopy code?




Answer: Code 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) is right for fluoro used for gastric band adjustment in the outpatient setting, according to the American Hospital Association's Coding Clinic for HCPCS Vol. 9, No. 3, 2009. Of course, the code is only right when the doctor uses and documents the fluoroscopic guidance.




The procedure: LAP-BAND adjustment involves passing a needle into the port of a band placed around the patient's stomach as part of bariatric surgery. The radiologist makes use of the needle to add or remove fluid to alter the width of the stoma.




...
... The doctor typically carries out the adjustment through a subcutaneous port. If it is palpable, the doctor may not require guidance. However for patients who require to shed a lot of weight or for patients who've already lost weight and have a lot of extra skin, the radiologist may require guidance to trace the port.


Remember that adjustments are carried out during the bariartric surgery's global period are included in the surgical fee; as such you shouldn't report them separately. You may report adjustments carried out after the global postoperative period ends. For those (non-Medicare) payers who accept S codes, you may go for S2083 (Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline). Or else, you may have to include the service in the right E/M code, depending on payer preference.