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Basics of Bariatric Surgery CPT codes 43770-43775

Bariatric Surgery codes 43770-43775 also report procedures performed for gastric restrictive procedures that are accomplished by placing a restrictive device around the stomach to decrease its functional size. Code 43770 reports “placement of adjustable gastric restrictive device (e.g., gastric band and subcutaneous port components)” . The band is adjustable because the band is hollow and contains a tube that can be inflated with fluid. After surgery, fluid is gradually inserted into the tube through a subcutaneous port (just beneath the skin) with a syringe. The physician can adjust the amount of fluid in the tube and thereby adjust the amount of food that can pass through the banded area. The procedure may be performed on an outpatient basis and is reversible by removal of the banding apparatus.

Description of CPT code 43770, 43771, 43772, 43773 and 43774

The physician performs a laparoscopic gastric restrictive procedure in which an adjustable gastric restrictive device, such as a gastric band with subcutaneous port components, is inserted. This is a gastric restrictive procedure for treatment of morbid obesity that does not permanently alter the gastrointestinal tract. The physician places a trocar though an incision, generally above the umbilicus, and insufflates the abdominal cavity. The laparoscope and additional trocars are placed through small portal incisions. The silicone gastric band is introduced into the peritoneal cavity via a trocar and is placed and secured around the upper stomach to form a smaller stomach pouch with a narrowed outlet. A small port, or reservoir, is placed under the skin at the time of surgery and connected to the silicone band by tubing to facilitate postoperative adjustments of the outlet size by the addition or removal of saline via the port. The instruments are removed and the incisions are closed. CPT code 43770 is reported for this exam.

The physician performs laparoscopic revision of an adjustable gastric restrictive device. This revision is most often performed for slippage of the device or for dilation of the gastric pouch. The physician places a trocar though an incision, generally above the umbilicus, and insufflates the abdominal cavity. The laparoscope and additional trocars are placed through small portal incisions. Saline is removed from the gastric restrictive device and the device is repositioned around the upper stomach. Saline is slowly reintroduced through the existing port to secure the device position. Once the device is in place, the instruments are removed and the incisions are closed. CPT code 43771 reports revision of the device component only.

The physician performs laparoscopic removal of an adjustable gastric restrictive device component. The physician places a trocar though an incision, generally above the umbilicus, and insufflates the abdominal cavity. The laparoscope and additional trocars are placed through small portal incisions. Saline is removed from the gastric restrictive device and the component is removed. Once the device component has been removed, the instruments are withdrawn and the incisions are closed. CPT code 43772is reported for removal of an adjustable gastric restrictive device component only. CPT code 43773 is reported for removal and replacement of an adjustable gastric restrictive device component only.

43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)

43771 revision of adjustable gastric restrictive device component only

43772 removal of adjustable gastric restrictive device component only

43773 removal and replacement of adjustable gastric restrictive device component only

43774 removal of adjustable gastric restrictive device and subcutaneous port components

The physician performs laparoscopic removal of an adjustable gastric restrictive device and subcutaneous port components. The physician places a trocar though an incision, generally above the umbilicus, and insufflates the abdominal cavity. The laparoscope and additional trocars are placed through small portal incisions. Saline is removed from the gastric device and the device is removed. Once the device has been removed, the subcutaneous port components are removed. The instruments are withdrawn and the incisions are closed. CPT code 43774 is reported for this exam.