# IP surgery questions



## Verna (Aug 13, 2014)

Hello wonderful people. I have questions regarding IP surgery and ICD-9 procedure coding. I've always been an OP coder, but now I am coding for our new surgeon. I'm trying to stuggle through this one, but it's very daunting. We had a patient who had the following:

1. Attempted subclavian central line placement (aborted). I know how to code an aborted procedure for an OP using modifiers, but can someone guide me for IP status?

2. Exploratory laparotomy with sigmoid permanent colostomy. I found the code for the permanent colostomy, but may I code the laparotomy separately or is it bundled?

3. Two chest tube placements in one day; one small tube inserted upper right anterior chest, and later that day a 20-French chest tube. Confused as how to code this one.

Any help or guidance would be much appreciated.


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## mitchellde (Aug 13, 2014)

If you are coding for the surgeon you use the CPT codes.  ICD-9 procedure codes are used only by the facility coder.


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## JRustan (Aug 13, 2014)

mitchellde said:


> If you are coding for the surgeon you use the CPT codes.  ICD-9 procedure codes are used only by the facility coder.



ICD-9 codes are not procedure codes....


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## mitchellde (Aug 13, 2014)

I know that regarding vol 1 and 2 however the original poster requested ICD-9 procedure codes which are vol 3 used by facility coders only.


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## Verna (Aug 13, 2014)

I guess I needed to provide a bit more information. I work in a Critical Access Hospital and am the facility coder. That's why I need ICD-9 surgery coding for our inpatients.


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## mitchellde (Aug 13, 2014)

Ah I see when you stated that it was for a surgeon I wondered.  Aborted procedures do not get codes in the inpatient setting.  The ex lap is not bundled per se, it just is not coded.  The two chest tube placements, we always just coded one.


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## Verna (Aug 14, 2014)

Thank you for your help, I really appreciate it.


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## cynthiabrown (Aug 20, 2014)

As far as inpt procedure codes, don't you code to highest degree of what was accomplished ???  ex. aborted choly would go to incision of abdomen if that is alll the farther they got???


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