CPT CODES

CPT Code 43773

CPT code 43773 is a medical billing code for laparoscopic replacement of a gastric adjustable device.

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What is CPT Code 43773

CPT code 43773 is used to describe a laparoscopic procedure for the replacement of a gastric adjustable device. This code specifically refers to the surgical intervention where a healthcare provider removes an existing adjustable gastric band or device and replaces it with a new one, utilizing minimally invasive laparoscopic techniques. This procedure is typically performed on patients who have undergone bariatric surgery and may require adjustments or replacements of their gastric devices for effective weight management.

Does CPT 43773 Need a Modifier?

For CPT code 43773, the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to perform the procedure is substantially greater than typically required.

2. Modifier 52 - Reduced Services: Indicates that a service or procedure is partially reduced or eliminated at the physician's discretion.

3. Modifier 53 - Discontinued Procedure: Used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

4. Modifier 59 - Distinct Procedural Service: Indicates that a procedure or service was distinct or independent from other services performed on the same day.

5. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure.

6. Modifier 66 - Surgical Team: Used when a highly complex procedure is carried out by a surgical team.

7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Indicates a return to the operating room for a related procedure during the postoperative period.

8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when a procedure or service performed during the postoperative period is unrelated to the original procedure.

9. Modifier 80 - Assistant Surgeon: Indicates that an assistant surgeon was required for the procedure.

10. Modifier 81 - Minimum Assistant Surgeon: Used when an assistant surgeon provides minimal assistance during the procedure.

11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Indicates that an assistant surgeon was necessary because a qualified resident surgeon was not available.

12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Used when these non-physician practitioners assist in surgery.

Each of these modifiers serves a specific purpose and should be used in accordance with the guidelines to ensure accurate billing and reimbursement.

CPT Code 43773 Medicare Reimbursement

CPT code 43773 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's essential to verify with your local MAC for any specific coverage guidelines or documentation requirements associated with this code.

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