CPT® Code 0156T | Case2Code

Code deleted, see 43659

Official Description

Laparoscopy, surgical; revision or removal of gastric stimulation electrodes, lesser curvature (ie, morbid obesity)

Common Language Description

The procedure described by CPT® Code 0156T involves the laparoscopic revision or removal of gastric stimulation electrodes specifically located at the lesser curvature of the stomach. Gastric stimulation electrodes are devices that are surgically implanted to assist in the management of morbid obesity, particularly in patients who may also have diabetes. The primary function of these electrodes is to reduce food intake and delay gastric emptying, which can contribute to weight loss and improved metabolic control. The procedure utilizes a pacing lead system, commonly referred to as a gastric pacemaker, which consists of a generator device and two stimulation leads. The generator is implanted in a subcutaneous pocket created in the abdominal wall, typically beneath the rib cage, while the stimulation leads are inserted into the muscle wall of the stomach. This is achieved through laparoscopic techniques, which involve the use of specialized instruments to minimize invasiveness. The leads are then tunneled under the skin and connected to the generator, allowing for the delivery of electrical stimuli to the stomach. These stimuli can be administered in various patterns, such as long pulses in continuous cycles or pulse trains that oscillate on and off, to effectively manage gastric function. The use of CPT® Code 0156T is specifically designated for cases where there is a need to revise or remove these gastric stimulation electrodes.

1. Indications

The laparoscopic revision or removal of gastric stimulation electrodes is indicated for patients who have undergone previous gastric stimulation procedures and may require adjustments or removal of the electrodes due to various reasons. These indications may include:

Device Malfunction - Instances where the gastric stimulation system is not functioning as intended, leading to inadequate therapeutic effects.
Adverse Effects - Patients experiencing negative side effects from the gastric stimulation, such as discomfort or complications related to the electrodes.
Weight Management Issues - Situations where the initial gastric stimulation has not resulted in the desired weight loss or metabolic improvement, necessitating a revision or removal.
Change in Patient Condition - Changes in the patient's health status or weight management goals that may require the removal of the stimulation system.

2. Procedure

The laparoscopic revision or removal of gastric stimulation electrodes involves several key procedural steps:

Step 1: Anesthesia Administration - The procedure begins with the administration of general anesthesia to ensure the patient is comfortable and pain-free throughout the surgery.
Step 2: Laparoscopic Access - The surgeon creates small incisions in the abdominal wall to insert laparoscopic instruments. This minimally invasive approach allows for better visualization and access to the stomach.
Step 3: Identification of Electrodes - Using laparoscopic cameras and instruments, the surgeon locates the gastric stimulation electrodes that need to be revised or removed. This step is crucial for ensuring that the correct components are addressed during the procedure.
Step 4: Revision or Removal - Depending on the indication, the surgeon either revises the positioning of the electrodes or completely removes them from the lesser curvature of the stomach. Care is taken to minimize trauma to surrounding tissues.
Step 5: Closure of Incisions - After the revision or removal is completed, the surgeon carefully closes the incisions using sutures or surgical adhesive, ensuring that the site is secure and healing can begin.

3. Post-Procedure

Post-procedure care following the laparoscopic revision or removal of gastric stimulation electrodes typically includes monitoring the patient for any immediate complications, such as bleeding or infection. Patients may be advised to follow a specific diet and gradually reintroduce solid foods as tolerated. Pain management strategies will be implemented to ensure comfort during recovery. Follow-up appointments are essential to assess the surgical site and evaluate the patient's progress in weight management or any other related health concerns. Additionally, patients may receive guidance on lifestyle modifications to support their overall health and weight loss goals.

Short Descr	LAP REMV GAST CURVE ELECTRD
Medium Descr	LAPS REVJ/RMVL GASTRIC ELTRD < CURVATURE
Long Descr	Laparoscopy, surgical; revision or removal of gastric stimulation electrodes, lesser curvature (ie, morbid obesity)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	94 - Other OR upper GI therapeutic procedures