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The procedure described by CPT® Code 43773 involves a laparoscopic surgical intervention specifically aimed at the removal and replacement of a component of an adjustable gastric restrictive device, commonly known as a gastric band. This type of surgery is typically indicated when there is a complication such as slippage of the gastric band, which can occur over time. The gastric band is designed to restrict the amount of food that can be consumed by creating a small pouch in the stomach, thereby aiding in weight loss for patients with obesity. During this procedure, a Veress needle is initially used to insufflate the abdomen, allowing for better visualization and access to the surgical site. Trocars are then introduced to facilitate the insertion of laparoscopic instruments. A nasogastric tube is also placed to decompress the stomach, ensuring that the surgical field is clear. The surgical team dissects the gastric band free from surrounding tissues, unlocks it, and repositions it as necessary. The replacement of the gastric band involves careful manipulation and adjustment to ensure proper placement and function. This procedure is distinct from other related codes, such as CPT® 43771, which involves a revision without replacement, and CPT® 43774, which includes the removal of both the gastric band and the subcutaneous port components. The meticulous nature of this laparoscopic approach allows for reduced recovery time and minimal invasiveness compared to open surgical techniques.
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The laparoscopic surgical procedure described by CPT® Code 43773 is indicated for patients experiencing complications related to their adjustable gastric restrictive device, specifically when slippage of the gastric band occurs. This condition may lead to inadequate restriction of the stomach, resulting in weight regain or other gastrointestinal issues. The procedure is performed to restore the proper function of the gastric band, ensuring that it effectively aids in weight management and minimizes the risk of further complications.
The laparoscopic procedure begins with the insertion of a Veress needle into the abdominal cavity to insufflate the abdomen with carbon dioxide gas. This insufflation creates a working space for the surgeon to operate. Following this, trocars are introduced to allow the placement of laparoscopic instruments. A nasogastric tube is then placed to decompress the stomach, which helps to provide a clearer view of the surgical area. The surgeon carefully dissects the gastric band free from surrounding tissues, ensuring that it is unlocked and can be repositioned as necessary. In this specific procedure, the defective gastric band is not only removed but also replaced. An endo grasp is introduced and passed through the retrogastric tunnel until it is visible in the phrenogastric window, where it is advanced to grasp the diaphragm. The replacement gastric band is then introduced and secured around the stomach using the endo grasp. The position of the band is meticulously checked and adjusted to ensure optimal placement before it is locked in position. Saline solution is injected into the inflatable balloon of the gastric band to calibrate the tension appropriately. The tube is clamped, and any redundant portions are cut and removed to finalize the setup. Finally, the band is secured with sutures and connected to the existing reservoir, ensuring that it is ready for postoperative adjustment, which is typically performed in the radiology department.
After the laparoscopic gastric band replacement procedure, patients are typically monitored for any immediate complications. Postoperative care includes managing pain and ensuring that the patient is stable before discharge. Patients may be advised to follow a specific diet and gradually reintroduce solid foods as tolerated. Follow-up appointments are essential for monitoring the adjustment of the gastric band, which is usually performed in the radiology department. During these follow-ups, the tension of the band may be adjusted to optimize its effectiveness in restricting food intake. Patients should be informed about signs of potential complications, such as nausea, vomiting, or abdominal pain, and instructed to seek medical attention if these occur.
| Short Descr | LAP REPLACE GASTR ADJ DEVICE | Medium Descr | LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE | Long Descr | Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 244 - Gastric bypass and volume reduction |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
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| 2008-01-01 | Changed | Code description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |
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