# Please help with CPT code.



## coder25 (Feb 21, 2011)

Good afternoon!

I am not sure how to code a laparoscopic repair of a perforated duodenal ulcer.  

Would I use the unlisted stomach, 43659 code or just use CPT code 43840? 

Thanks in advance for your help!


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## Bwray (Feb 22, 2011)

I would code CPT 43840 and try not to use unlisted codes if possible.


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## mitchellde (Feb 22, 2011)

No you cannot use an open procedure code for a laprascopic procedure.  Some will tell you to code the open procedure with a 52 modifier, however in speaking with numerous surgeons, they feel that they do more work when using the laprascopic approach as to the open approach so this is not good for them.  Therefore the more appropriate way is to use the unlisted code.  You will need to also put a procedure descriptor in the line above the code, or some payers let you put this in box 19 along with a compare to code for the expected RVU value.


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## Bwray (Feb 22, 2011)

Debra 
Thank you for clarification on that code, I should have posted the same question last week and then I wouldn't be submitting a corrected claim.

Brenda Wray CPC


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## NaliniAAPC (Feb 23, 2011)

Hi,
I agee with Debra.
laparoscopic repair of a perforated duodenal ulcer-43659

Nalini CPC


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## thangaraj (Jul 23, 2013)

My suggestion will be to use unlisted procedure code 44238 instead of 43659. Duodenum is part of small intestine, hence CPT 44238 will be more appropriate than 43659.

Thangaraj.A CPC


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