# DX Lap, median pancreatectomy with Rounx-en-Y pancreatic jejunenostomy...



## cedwards (Oct 17, 2008)

We are going to be performing a procedure on a patient whose insurance we are not par with.  We are in the process of negotiating a fee with the insurance company.  Here is the scenario of what the provider plans on performing.  Please help me choose the CPT codes...

Diagnostic laparoscopy, then a median pancreatectomy with a Roux-en-Y pancreatic jejuenostomy and possible subtotal pancreatectomy and splenectomy.  Diagnosis is cystic neoplasm of the pancreas.

Any help would be greatly appreciated.

Thanks!


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## lavanyamohan (Oct 18, 2008)

Hello,
A diagnostic laparascopy with a Roux-en-Y pancreatic jejunostomy may not be paid on the same date of service.
Also, a subtotal pancreatectomy encompasses a median pancreatectomy and these too should not be billed for the same DOS.
Suggestion-
If you want both the jejunostomy and splenectomy billed, it is safe to include the type of neoplasm-whether benign or malignant.
The reason is, for benign neoplasm only a median pancreatectomy and probably the diagnostic laparoscopy will end up getting paid.


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