410 Ind. Admin. Code 28-1-8
Authority: IC 16-40-3-5
Affected: IC 16-40-3
Sec. 8.
"Surgical treatment" means any of the following procedures:
Current Procedural Terminology (CPT) Codes
43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en Y gastroenterostomy (roux limb 150 cm or less)
43645 Laparoscopic, gastric restrictive surgery, with gastric bypass and Roux-en Y gastroenterostomy (roux limb 150 cm or less) with small bowel reconstruction to limit absorption
43770 Laparoscopic surgical gastric restrictive procedure. Placement of adjustable gastric band
43842 Gastric restrictive procedure, without gastric bypass; vertical-banded gastroplasty (VBG)
43843 Gastric restrictive procedure, other than vertical-banded gastroplasty
43845 Biliopancreatic diversion with duodenal switch
43846 Gastric restrictive surgery, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en Y gastroenterostomy
43847 Gastric restrictive surgery, with gastric bypass and Roux-en Y gastroenterostomy (roux limb 150 cm or less) with small bowel reconstruction to limit absorption
43848 Revision of gastric restrictive procedure for morbid obesity (separate procedure)
410 IAC 28-1-8