Billing and Coding: Surgical Management of Morbid Obesity

Medicare coverage excludes open gastric restrictive procedures and associated open port replacement CPTs (43886–43888) and specific open gastroplasty codes (43842, 43843) per NCD 100.1. Covered laparoscopic restrictive procedures requiring port replacement should be billed with CPT 43771, 43772, or 43773, and all billing must follow LCD L33411 reasonable and necessary requirements; thorough, legible medical record documentation (including H&P, operative reports, failed medical therapy, testing/imaging, psychological clearance when indicated, and smoking history/counseling) must be maintained and available upon request.

"For covered laparoscopic restrictive procedures that require port replacement, bill CPT code 43771, 43772, or 43773."

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