How To Use CPT Code 43847

CPT 43847 describes a gastric restrictive procedure with gastric bypass for morbid obesity, which includes a small intestine reconstruction to limit absorption. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43847?

CPT 43847 is a code used to describe a surgical procedure performed to treat severe obesity. It involves a gastric restrictive procedure with gastric bypass, along with a small intestine reconstruction to limit absorption. This procedure helps patients lose weight over time by restricting food intake and minimizing caloric absorption.

2. Official Description

The official description of CPT code 43847 is a gastric restrictive procedure with gastric bypass for morbid obesity, including small intestine reconstruction to limit absorption. It is important to note that this procedure involves a more extensive rerouting of the small intestine, longer than 150 cm, to further limit absorption.

3. Procedure

1. The surgeon begins by administering general anesthesia to the patient.
2. A small section of the stomach is divided, usually with staples.
3. The small intestines are also divided.
4. One portion of the small bowel is attached to the new stomach pouch.
5. The other portion of the bowel is used to create a “bypass” before rejoining it to the main portion of the small intestine.
6. This procedure effectively restricts food intake and limits absorption, aiding in weight loss over time.

4. Qualifying circumstances

CPT 43847 is performed on patients with severe obesity, also known as morbid obesity. These patients have a body mass index (BMI) greater than 35-40 kg/m2 or are at least 100 pounds over their ideal weight. The procedure is intended for individuals who have not been able to achieve weight loss through other means and require surgical intervention. It is important to check with the payer to determine coverage for operative procedures for morbid obesity.

5. When to use CPT code 43847

CPT code 43847 should be used when a gastric restrictive procedure with gastric bypass and small intestine reconstruction is performed to treat morbid obesity. It is important to ensure that the patient meets the qualifying circumstances for this procedure and that other non-surgical weight loss methods have been unsuccessful.

6. Documentation requirements

To support a claim for CPT 43847, the following documentation is required:

• Patient’s diagnosis of morbid obesity
• Details of the gastric restrictive procedure with gastric bypass and small intestine reconstruction
• Date of the procedure
• Operative notes describing the steps performed during the surgery
• Any complications or additional procedures performed
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 43847, it is important to follow the billing guidelines. This procedure may not be covered by Medicare or other payers, so it is essential to check with the payer to determine coverage. It is also important to note that CPT code 43847 should not be reported with other codes, such as CPT codes 43846 or 43644, which are used for different procedures related to gastric bypass and small intestine reconstruction.

8. Historical information

CPT code 43847 was added to the Current Procedural Terminology system on January 1, 2002. It underwent a historical change on that date, with the description being modified to include small bowel reconstruction to limit absorption. There have been no further updates to the code since its addition.

9. Examples

1. A patient with morbid obesity undergoes a gastric restrictive procedure with gastric bypass and small intestine reconstruction to limit absorption.
2. A surgeon performs CPT 43847 on a patient who has not been able to achieve weight loss through non-surgical methods.
3. A gastric bypass with small intestine reconstruction is performed on a patient with severe obesity to aid in weight loss.
4. A morbidly obese individual undergoes a gastric restrictive procedure with gastric bypass and small intestine reconstruction to limit caloric absorption.
5. A surgeon performs CPT 43847 on a patient with a BMI greater than 35-40 kg/m2 to help them lose weight.
6. A gastric restrictive procedure with gastric bypass and small intestine reconstruction is performed on a patient who meets the qualifying circumstances for CPT 43847.
7. A patient with severe obesity undergoes a surgical procedure involving a gastric bypass and small intestine reconstruction to limit absorption.
8. CPT 43847 is performed on a morbidly obese individual to aid in weight loss.
9. A surgeon performs a gastric restrictive procedure with gastric bypass and small intestine reconstruction on a patient with a BMI over 35-40 kg/m2.
10. A patient with severe obesity undergoes CPT 43847 to help them achieve weight loss.