Some potentially big news came out a couple of days ago.
LAP-BAND® now has its own CPT code from the AMA!
As many of you know, the way a physician files for a service performed is by providing a CPT code to the insurance company.
When a new service is 'invented' there is generally a several year lag period until a CPT code is assigned. Until that point the physician needs to use an 'unlisted procedure' code which has been the case until now for LAP-BAND®. This creates problems for both the patient and the physician, since the insurance company can essentially say 'this procedure doesn't officially exist' and will assign any value to it that they wish, or just deny it.

The new code is valid January 1, 2006 I am told. It is 43770.
43770 – Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric band (gastric band and subcutaneous port components).

In our practice we will probably have people who were denied coverage for the LAP-BAND® being 'investigational' or 'experimental' refile with their insurance company January 1st. However, the new CPT code will probably not help those who have an outright exclusion for morbid obesity surgery on their policy.

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Dr. Ron Hekier, Texarkana LAP-BAND®®® Surgeon
LAP-BAND®®® Texarkana ( Texas | Arkansas )

http://blog.noscales.com
Disclaimer:
All information posted by me is my personal opinion and does not reflect views sanctioned by any other body or entity. Posts on this board should not be construed to be offered as medical advice or a professional opinion.