AHA Coding Clinic® for HCPCS - 2023 Issue 3; Ask the Editor

Laparoscopic biliopancreatic diversion with duodenal switch

A patient with morbid obesity presented to the hospital’s outpatient department for a laparoscopic biliopancreatic diversion with duodenal switch. The peritoneum was insufflated and trocars were introduced. First, a sleeve gastrectomy was created by dissection of the gastric vessels proximal to the pylorus up to the left crus. A 40 French bougie was positioned for sleeve sizing. The stomach stapling was completed avoiding the esophagus.Next, the duodenum was divided at the distal bulb just past the vein of Mayo. The small bowel bypass was measured out, marked and divided distally to create a 170 cm roux limb. This loop of small bowel was brought up to the duodenal end to create the duodenoileostomy in an end-to-side stapled anastomosis.Attention was turned to the distal bypass. The distal alimentary limb was then marked at 130 cm. Continuity with the biliopancreatic limb was created between by anastomosing the two at the distal 100 cm junction with a side-to-side functional anastomosis to form the common channel. The remaining enteroenterotomy was closed with sutures. The gastric specimen was extracted through the 15 mm trocar site and the fascia and skin were closed.Which CPT codes are reported for this laparoscopic biliopancreatic diversion with duodenal switch procedure? ...

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