Question:
CPT and ICD-9 Codes

Can anyone tell me what CPT code the surgeons use for this surgery? And I believe that the ICD-9 code for morbid obesitey is 278.0--I want to call my insurance carrier to find out if this procedure (and diagnosis code) is covered. Any info about billing and ICD-9 codes will be greatly appreciated !!!!!!! Thank You !!!!!!!!!!!    — K D. (posted on August 1, 2001)

July 31, 2001
Well KD, I think we need to know WHICH surgery you're having, and its specifics (RNY, DS, open,lap, etc) since the codes vary with the procedure and to a certain extent, which codes they use can vary by Doctor. My first surgeon pre-authorized one code for my DS and when I switched surgeons and they had to resubmit for authorization, they used a different one!
   — ChristiMNB

August 1, 2001
I can't believe this question....I'm a certified coder and a reimbursement specialist! the icd9 code for morbid obesity is 278.01. The Cpt code for the surgery would depend upon they type of surgery done. I would need to know exactly what the surgeon did to code it...or what he plans to do.
   — [Anonymous]

August 1, 2001
Here is the site you can go look up the specific code at: http://cedr.lbl.gov/icd9.html
   — [Anonymous]

August 1, 2001
Unless you are a certified medical coder, don't look up any codes yourself. It's much more complicated that just looking it up in a book. And you certainly can't "borrow" a code from some persons claim. Leave this up to your physcian and the pre-approval people in his office. If you start throwing inappropriate codes around you can really muck everything up and create unecessary insurance delays.
   — [Anonymous]

August 1, 2001
I know it is hard to hear but please leave the coding to the coders. It is possible that you have additional diagnosis codes to back up your need for surgery so you don't want to blow it by giving them one code and then finding out that isn't what your surgeon had planned to use.
   — Shannon S.

August 1, 2001
Folks, I believe she simply wants the codes to inquire about what procedures her insurance covers. I don't think she is going to file paperwork or request coverage, she is just making inquiries. Now, having said that, I would make certain you point out to the benefits person you speak to that you are not requesting coverage, just information.
   — [Anonymous]

August 2, 2001
The approval process doesn't work that way. Trust me, I do this for a living. No insurer would ever ask the patient for cpt/icd9 codes. That information should only come from the physcian....sometimes it isn't even one single code...it can be a combination of codes. I've seen more approvals get mucked up and delayed by anxious patients than I can even count. I'm a bit sensitive to this now because I'm currently working on getting approval for a surgical procedure for pretty sick 5 year old. The patient is coming from out of state and the mom wanted to "help". She started calling the insurer and sending letters and furnishing cpt codes (outdated ones !!!) before the surgeon had received an approval or a denial. Her "codes" were different from the surgeon's...everything is all screwed up....we'll eventually undo the "help" and get the approval...but this kid won't have the procedure done this month...we had to take him off the doc's OR schedule. Of course Mom is furious with the surgeon's office and with the hospital for "not doing enough".
   — [Anonymous]

August 3, 2001
I find it insulting that medical coding is treated like some big secret, If it is complicated, explain it. Look at all the information,much more complicated than coding,that is shared on this and other web sites to lay people. We all need to be informed consumers. And yes, insurance companies do ask us for codes. I had my insurance co ask me for a procedure code when I called to ask if I needed a second opinion regarding cataract surgery. Empower the consumer!!!!
   — kathleen S.

September 4, 2001
Well first of all I've been off line for a month and was looking forward to seeing if there was an answer or two to my billing question...This response is actually more of a comment rather then a question...I would like to thank those of you who answered in a positive way. I am aware of the different dx codes/cpt coding. I used to do medical billing myself. However I am no longer in that field therefore do not have access to that information. I was basically just looking for some guidlines so when I called my insurance company and can better present my question. Perhaps it is my fault that I did not better clarify myself. Anyway, again, THANK YOU to those of you who were trying to help and to the others (in particular the person who signed "anonymously" on 8/1 who started their question with "I can't believe this question")shame on you. I am trying to better myself and gain knowledge and I feel like you totally shot me down. I feel like if I ever have a different question maybe I shouldn't post it to this board if I am going to be made to feel like an idiot. This board is supposed to be supportive and when you answer a question in the manner that you did--well...it's not very supportive and I don't appreciate your response. So unless you can answer your question in a postive and supportive way please do everyone a favor and don't respond.
   — K D.

January 19, 2002
This is a list of codes I found on a yahoo site. Hope this helps. General ICD Code Morbid (Malignant) Obesity 278.01 Chronic Compartment Syndrome 9-V47.1 Cardiovascular Hypertension 402.90 437.2 Gatrointestinal Severe gastroesophaegeal reflux 530.81 Diaphragmatic hernia 553.3 Heartburn 787.1 Nutritional/Metabolic Endocrine metabolic & immunity disorders 9-V12.2 Dietary surveillance & counseling 9-V65.3 Inappropriate diet & eating habits 9-V69.1 Fluid retention 782.3 Respirtory Sleep Apnea 9-780.57 Mental Disorders Prolonged depressive adjustment reaction 9.309.3 Misery & unhappiness disorder 9-313.1 Depression 9-311 Obsessive compulsive [Compulsive Eater] 296.3 Eating disorder 9-307.50 Adjustment to chronic stress 9-309 Under-socialized conduct disorder 9-312.1 Social withdrawal disorder 9-313.2 Neurologic Peripheral autonomic neuropathy 337.0 Genitourinary Menstral disorders 626.9 Stress urinary incontinence 9-788.3 Skin/Subcutaneous tissue Hirsutish 9-704.1 Decubitius ulcer 9-707.0 Omtertrogompis fimga; 9-111.9 Musculoskeletal/Connective tissue Lower leg including knee 9-715.06 Joint stiffness 9-719.7 Lumbar disc disorder displacement 9-722.10 Thoractic back pain from large breasts 9-724.1 Low back pain syndrome 9-724.2 Limb swelling 9-729.81 Gait abnormality 9-781.2 Lumbar strain 9-845.0 Ankle strain 9-845.0 Plantar fascitis 9-728.71 Knee strain 9-844.9 Lack of physical exercise 9-V69.0 Immobiity imparirment 9-V49.1 Ventral hernia 9-533.1 Umbilical hernia 9-553.20 Inguinal hernia 9-550.9
   — fudgiepete

January 19, 2002
OMG Michelle! Misery and Unhappiness disorder??? Now I have heard everything. That's a new one to me but I guess the docs will think up everything someday. I just thought that this was alittle funny cause I guess we all suffer from that at some point in time. I never thought of it as a diagnosis! Thanks for the smile.
   — Barbara H.

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