Background

Current Procedural Technology (CPT) codes are used to identify an interaction between a surgeon and patient. Innovative or uncommon procedures do not have specific codes. Instead, an 'unlisted' code is used. Bariatric surgeons commonly use 43659, unlisted laparoscopy procedure, stomach. This study examines use of CPT code 43659 in an academic bariatric surgical practice.

Methods

The electronic billing platform for an academic practice was queried over an 8-year period (1/2015 to 12/2022). A list of procedures using 43659 was generated and reviewed by a coding expert. Collected data includes surgeon, date of service, and procedure.

Results

Over an 8-year period, use of 43659 increased by 650% (7 in 2015, 46 in 2022). The percentage of procedures represented by 43659 increased from 1.5% (2016) to 15.4% (2021). The number of surgeons changed with 1 registering in 2015 and 5 in 2017, 2019, and 2021. The most common procedures include revision of gastric bypass and duodenal switch. On average, the number of procedures performed by each surgeon increased from 1 (2016) to 11.5 (2022). However, in 2022, 33 of 46 (71.7%) of the procedures were performed by 1 surgeon.

Conclusions

The majority of procedures performed by bariatric surgeons are mainstream techniques represented by standard CPT codes. However, surgeons performing revisional or less common operations use an unlisted code. In this academic surgical practice, appropriate use of CPT code 43659 increased significantly over 8 years. This study emphasizes the importance of unlisted CPT codes on ASMBS members with potential significant economic impact.