1. Variable Name: Staple Line Reinforcement

Appendix A: Variable Definitions

1. Variable Name: Staple Line Reinforcement

Intent of Variable: To identify if a staple line reinforcement product was utilized for the case.

Definition: See Criteria below

Criteria: Document whether or not a staple line reinforcement product was used

Options:

1.  Yes, if mentioned it was used

2.  No, not documented or not used

Scenarios to Clarify (Assign Variable):

1.  Answer all questions if the case is assigned with CPT code 43775 as the principal operative procedure.

2.  Assigned if bioabsorable products, collagen mesh, Peri Strips©, etc. were used. Some examples that you may see are Biodesign© and Seamguard© .

Scenarios to Clarify (Do Not Assign Variable):

1.  The principal operative procedure for the case is not 43775.

2.  Do not assign if Evicel© , Surgicel© , Ligaclips© , and/or sutures were used

2. Variable Name: Oversew

Intent of Variable: To identify if a majority of the suture line was oversewn.

Definition: See Criteria below

Criteria: Document whether or not all or the majority of the staple line was sutured.

Options:

1.  Yes, if oversew all or majority of staple line.

2.  No, if no oversewing or if only limited oversewing of bleeders or notches between staple fires only or if not documented.

Scenarios to Clarify (Assign Variable):

1.  Answer all questions if the case is assigned with CPT code 43775 as the principal operative procedure.

Scenarios to Clarify (Do Not Assign Variable):

2.  The principal operative procedure for the case is not 43775.

3. Variable Name: Bougie (or sizing device) size

Intent of Variable: To capture the size of the device utilized to create the gastric sleeve.

Definition: See Criteria below

Criteria: Please indicated bougie (or other sizing device, eg. Endoscope or OG tube) size in French or cm. Please note that you must enter a value or check “not documented” for case completion.

Options:

1.  Size: French (FR) or Centimeters (cm).

2.  Unknown

Scenarios to Clarify (Assign Variable):

1.  Answer all questions if the case is assigned with CPT code 43775 as the principal operative procedure.

Scenarios to Clarify (Do Not Assign Variable):

1.  The principal operative procedure for the case is not 43775.

4. Variable Name: Distance from the Pylorus (in cm)

Intent of Variable: To capture the distance from the pylorus where the staple line is started.

Definition: See Criteria below

Criteria: Enter the distance from the pylorus where the staple line is started.

Options:

1. Distance from the pylorus in cm

2.  Not Documented

Scenarios to Clarify (Assign Variable):

1.  Answer all questions if the case is assigned with CPT code 43775 as the principal operative procedure.

Scenarios to Clarify (Do Not Assign Variable):

1.  The principal operative procedure for the case is not 43775.

Notes:

1.  A value must be entered or check “not documented” for case completion.