CPT® Code 0155T

Code deleted, see 43659

Official Description

Laparoscopy, surgical; implantation or replacement of gastric stimulation electrodes, lesser curvature (ie, morbid obesity)

Common Language Description

The procedure described by CPT® Code 0155T involves the laparoscopic implantation or replacement of gastric stimulation electrodes specifically located in the lesser curvature of the stomach. This surgical intervention is primarily indicated for the treatment of morbid obesity, particularly in patients who may also be diabetic. Gastric stimulation works by reducing food intake and delaying the process of gastric emptying, which can aid in weight management and improve metabolic control in these patients. The procedure utilizes a pacing lead system, commonly referred to as a gastric pacemaker, which consists of a generator device and two stimulation leads. The generator is surgically implanted into a subcutaneous pocket created in the abdominal wall, typically beneath the rib cage, ensuring it is securely positioned. The two lead wires, equipped with electrodes, are then inserted into the muscle wall of the lesser curvature of the stomach using laparoscopic instruments. These leads are carefully tunneled under the skin and connected to the generator, allowing for the delivery of electrical stimuli to the stomach. The stimulation can be administered in various forms, including long pulses in continuous cycles or pulse trains that oscillate on and off for brief intervals. For cases requiring laparoscopic revision or removal of gastric stimulation electrodes, CPT® Code 0156T should be utilized.

1. Indications

The laparoscopic implantation or replacement of gastric stimulation electrodes is indicated for the following conditions:

Morbid Obesity This procedure is primarily performed on patients diagnosed with morbid obesity, where traditional weight loss methods have been ineffective.
Diabetes It is particularly beneficial for diabetic patients, as gastric stimulation can help in managing weight and improving metabolic control.

2. Procedure

The procedure for the laparoscopic implantation or replacement of gastric stimulation electrodes involves several key steps:

Step 1: Anesthesia Administration The patient is placed under general anesthesia to ensure comfort and immobility during the surgical procedure.
Step 2: Laparoscopic Access Small incisions are made in the abdominal wall to allow the insertion of laparoscopic instruments. A camera is introduced to provide visualization of the surgical field.
Step 3: Creation of Subcutaneous Pocket A subcutaneous pocket is created beneath the rib cage in the abdominal wall where the generator device will be implanted. This pocket is carefully fashioned to securely hold the device.
Step 4: Electrode Placement Two intramuscular lead wires with electrodes are implanted into the muscle wall of the lesser curvature of the stomach. This is done using laparoscopic instruments to ensure precision and minimize trauma.
Step 5: Tunneling of Leads The lead wires are tunneled under the skin from the stomach to the generator pocket, ensuring that they are properly positioned and secured.
Step 6: Connection to Generator The electrodes are connected to the generator device, which is then placed in the subcutaneous pocket. This connection allows for the delivery of electrical stimuli to the stomach.
Step 7: Testing and Closure The system is tested to ensure proper function before the incisions are closed. The laparoscopic instruments are removed, and the incisions are sutured or stapled as necessary.

3. Post-Procedure

After the laparoscopic implantation or replacement of gastric stimulation electrodes, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-procedure care may include pain management, instructions for activity restrictions, and dietary modifications. Patients are advised to follow up with their healthcare provider to monitor the effectiveness of the gastric stimulation and to make any necessary adjustments to the device settings. Recovery time may vary, but most patients can expect to resume normal activities within a few weeks, depending on individual healing and response to the procedure.

Short Descr	LAP IMPL GAST CURVE ELECTRD
Medium Descr	LAPAROSCOPIC IMPLTJ/RPLCMT GASTRIC ELECTRODE
Long Descr	Laparoscopy, surgical; implantation or replacement of gastric stimulation electrodes, lesser curvature (ie, morbid obesity)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	94 - Other OR upper GI therapeutic procedures