Resolved Laparoscopic Roux-en-Y [not for obesity]

[ErnaV_2250]

Morning CCO team,
Please can I ask for advice.
I need clarification on a Gastric bypass with Roux&Y code – done Laparoscopically. The patient was diagnosed with a pyloric stenosis and obstruction and unable to dilate.

Both available Lap codes indicate restrictive – it just feels that these codes are more relevant to obesity treatment, this patient not overweight at all, and according to the Desk reference both procedures are done for absorption limitation.
43644, 43645 both include 'restrictive procedure'.

What code do you suggest are used for this patient? as it is definitely not for obesity surgery?

Thanks
Erna

 

[KarenE_90617]

According to the 2025 CPT book, starting at the beginning of Laparoscopy it will provided some information and suggested codes to use for other procedures that are relevant however 43846 Gastric Bypass for Morbid Obesity (page 369) is appropriate for a patient who has been diagnosed with morbid obesity. Clearly if this patient has not been diagnosed with morbid obesity in addition to the pyloric stenosis then 43644 would be the correct code as the parenthetical message states that to use code 43645 for blockages greater than 150cm anything less than 150cm is 43644 (page 366). Pay close attention to the parenthetical messages as it will lead to you to the correct codes to use.