# ICG (Indocyanine green)



## KoBee (Apr 28, 2021)

Hello everyone -

is anyone familiar with the correct CPT code to use for ICG during cholecystectomy? done some research and states it may be integral to main procedure but then I read that you can code it separately, a bit confused, appreciate any feedback.

I have providers trying to use 99240 but I feel that is incorrect as it is an ophthalmology code.

Thank you


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## such78 (Apr 28, 2021)

https://www.medtronic.com/content/dam/covidien/library/us/en/services-support/reimbursement/icg-flourescence-imaging-nonopthalmic-procedures-reimbursement-coding-guide.pdf


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## csperoni (Apr 28, 2021)

No experience with ICG during cholecystectomy, only for sentinel lymph node identification during hysterectomy.
If you are performing it for sentinel lymph node identification, 38900 describes exactly the procedure, but is an add on code and you must also bill one of the base codes.  If done bilaterally, bill with both -RT and -LT.  If you are not billing one of the base codes, then use unlisted 38999 comparing to the work of 38900.
38900 Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)                                            
Notes: (Use 38900 in conjunction with 19302, 19307, 38500, 38510, 38520, 38525, 38530, 38531, 38542, 38562, 38564, 38570, 38571, 38572, 38740, 38745, 38760, 38765, 38770, 38780, 56630, 56631, 56632, 56633, 56634, 56637, 56640)
If you are NOT doing the ICG injection for sentinel lymph node identification, then the link from the first post gives some alternative codes depending on what you are doing the procedure for.


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## kajalgaonkar16 (May 2, 2021)

Indocyanine (ICG) or Firefly TM fluorescence is bundled into the cholecystectomy and is not separately billable.


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## Peterk50 (May 29, 2021)

With a LAP cholecystectomy (47562 or 47563), I have been able to bill 74300,26. It is not separately reportable with any of the colon resections.


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## KoBee (Jun 17, 2021)

kajalgaonkar16 said:


> Indocyanine (ICG) or Firefly TM fluorescence is bundled into the cholecystectomy and is not separately billable.


do you by any chance have reference/resource to this, I need to send something to providers so they don't think i'm making this up.


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## KoBee (Jun 17, 2021)

Peterk50 said:


> With a LAP cholecystectomy (47562 or 47563), I have been able to bill 74300,26. It is not separately reportable with any of the colon resections.


do you by any chance have reference/resource to this, I need to send something to providers so they don't think i'm making this up.


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## tcooper@tupelosurgery.com (Jun 19, 2021)

When I researched the billing of ICG with Cholecystectomy I found that Anesthesia bills for this. We cannot bill this as it is included in the 47562 and 47563. I would check with your Anesthesia Department and see if they are billing this. Hope this helps.


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## Mark Sonomura (Mar 7, 2022)

Here's a reference, KoBee . . .

*According to the online publication “General Surgery Coding Coach” . . .*

Billing for “Icy Green” Dye

October 15, 2020

*Question:*
The surgeon did a robotic/laparoscopic cholecystectomy and cholangiogram with icy green and firefly identification of biliary anatomy. He billed a 47563. Can he can bill separately for the icy green and firefly dye?

*Answer:*
Billing for indocyanine (ICG) or Firefly TM fluorescence is bundled into 47563 laparoscopic cholecystectomy with cholangiogram and is not separately billable.

_*This response is based on the best information available as of 10/15/20._

https://www.karenzupko.com/billing-for-icy-green-dye/

Hope this helps!


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## Peterk50 (Apr 18, 2022)

I have been able to bill 74300,26 with Lap Chol ...Medicare has paid it, UHC has not.


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