How To Use CPT Code 43774

CPT 43774 describes the laparoscopic surgical procedure for the removal of an adjustable gastric restrictive device and subcutaneous port components. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43774?

CPT 43774 can be used to describe the laparoscopic surgical procedure for the removal of an adjustable gastric restrictive device and subcutaneous port components. This code is used when a provider removes a previously placed gastric band with its components under laparoscopic guidance. The removal may be necessary due to displacement or malfunction of the band, erosion of the stomach wall caused by the band, or other reasons.

2. Official Description

The official description of CPT code 43774 is: ‘Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components.’ It is important to note that for the removal and replacement of both the gastric band and subcutaneous port components, a different code, 43659, should be used.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. A small incision is made in the belly button or lower abdomen.
3. The abdominal cavity is filled with carbon dioxide to lift the abdominal wall away from the internal organs.
4. A laparoscope is inserted through the incision, allowing the provider to visualize the abdominal area on video monitors in the operating room.
5. The provider examines the stomach and the gastric band to determine if repositioning, replacement, or removal is necessary.
6. If removal is required, the provider takes down any attachments to the band and subcutaneous port components and removes them through one of the laparoscopic ports.
7. Once the device components have been removed, the provider deflates the abdomen, removes the trocars, and closes the incisions with staples, stitches, or a special glue.

4. Qualifying circumstances

Patients who have previously undergone gastric restrictive procedures and require the removal of an adjustable gastric restrictive device and subcutaneous port components may qualify for CPT 43774. The removal may be necessary due to complications or the need for revision. It is important to note that CPT 43774 specifically refers to the removal of these components, and not their revision or replacement.

5. When to use CPT code 43774

CPT code 43774 should be used when a laparoscopic surgical procedure is performed to remove an adjustable gastric restrictive device and subcutaneous port components. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 43774, the provider must document the following information:

• Reason for the removal of the adjustable gastric restrictive device and subcutaneous port components
• Details of the laparoscopic procedure, including the incision site and the use of carbon dioxide for abdominal inflation
• Findings during the procedure, such as the condition of the gastric band and any complications
• Procedure duration
• Method of closure for the incisions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 43774, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the removal of the adjustable gastric restrictive device and subcutaneous port components. Additionally, be aware of any specific billing guidelines or modifiers that may be required by payers.

8. Historical information

CPT 43774 was added to the Current Procedural Terminology system on January 1, 2006. There have been some historical changes to the code, including updates to the code description and its inclusion or exclusion from certain lists, such as the Inpatient Only (IPO) list.

9. Examples

1. A provider performs a laparoscopic surgical procedure to remove an adjustable gastric restrictive device and subcutaneous port components for a patient who experienced erosion of the stomach wall caused by the band.
2. During a laparoscopic procedure, a provider removes an adjustable gastric restrictive device and subcutaneous port components due to displacement of the band.
3. A patient undergoes a laparoscopic surgical procedure for the removal of an adjustable gastric restrictive device and subcutaneous port components after experiencing complications with the band.
4. A provider performs a laparoscopic procedure to remove an adjustable gastric restrictive device and subcutaneous port components for a patient who requires revision of their gastric restrictive procedure.
5. During a laparoscopic surgical procedure, a provider removes an adjustable gastric restrictive device and subcutaneous port components for a patient who no longer requires the device for weight management.
6. A patient undergoes a laparoscopic procedure for the removal of an adjustable gastric restrictive device and subcutaneous port components due to malfunction of the band.
7. A provider performs a laparoscopic surgical procedure to remove an adjustable gastric restrictive device and subcutaneous port components for a patient who wishes to discontinue the use of the device.
8. During a laparoscopic procedure, a provider removes an adjustable gastric restrictive device and subcutaneous port components for a patient who experienced complications with the band.
9. A patient undergoes a laparoscopic surgical procedure for the removal of an adjustable gastric restrictive device and subcutaneous port components after achieving their weight loss goals.
10. A provider performs a laparoscopic procedure to remove an adjustable gastric restrictive device and subcutaneous port components for a patient who requires revision of their gastric restrictive procedure.