Billing and Coding: Periodic Adjustment of Gastric Restrictive Device after the Global Period

Adjustments of laparoscopic gastric restrictive devices (lap-band) billed with CPT 43999 are reimbursable only when performed in an office setting after the 90-day postoperative global period. CPT 43999 includes port imaging and is not payable the same day as an E/M unless the E/M is documented as a significantly separate service (append modifier 25); claims must include the narrative 'adjustment of lap-band'.

"Adjustment of a laparoscopic gastric restrictive device (lap-band) using CPT 43999 is covered when performed in an office setting after the 90-day postoperative global period."

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