# endoscopic pancreatic necrosectomy?



## JDV7980 (Mar 6, 2013)

Which CPT code would best report _endoscopic pancreatic necrosectomy_???

I cannot find a cpt code that reflects this procedure.  Would I use 48999, _"unlisted procedure, pancreas" _for this procedure? My physicians have reported 48105 in addition to the EGD code (43235-43259) in the past but this codes seems inappropriate since it is done through an abdominal incision.  

Any help would be appreciated.  Thank you!


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## darlenasmith (May 3, 2013)

*Answer?*

Did you ever get an answer to this question?  One of my docs if now performing this procedure and I am stumped.

Any help is appreciated.


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## JDV7980 (May 7, 2013)

Hi Darlenasmith.. I did, I spoke wtih my compliance manager and she stated that we should use an unlisted laparoscopy procedure code since there is no distinct CPT code... 
I inquired further about the laparoscopy codes because they are also done via abdominal incision and she stated since it is done with a scope it is ok to use (Per CPT assistant) and if there was an EGD unlisted code she would say to use that but unfortunately there is not. 

More unfortunately, there is also no _"unlisted laparoscopy, pancreas" _code...  I was thinking 43659, _"unlisted laparoscopy procedure, stomach"_ ???  I did read a few articles about how this procedure is done but you may want to verfiy with your own physician how he is performing it, I was actually doing the research for a physician who no longer works for us, he is doing this procedure now.   I read that the procedure is performed  through the mouth, the scope is advanced through the back side of the stomach wall in order to debride necrotic pancreas, a variety of instruments can be used to debride and the necrosis is dropped into the stomach. 

Once you have decided what unlisted laparoscopy code you will be reporting, document in the comment box of the claim form (box 19) _*"like" code of 48105, performed endoscopically"*_.  Just make sure that the physician documents exactly what he did in his report in case the insurance requests the documentation and I believe you would also set a fee comparable to the 48105 code but you may want to make sure and speak with your own compliance dept. and/or billing office if you have one.

Hope this helps...


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## darlenasmith (May 8, 2013)

*Thanks*

Thank you so much for responding.  I am actually going to meet with the doctor today to discuss further, but your information is very helpful as well.


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## JDV7980 (May 17, 2013)

You're welcome.  Good luck.


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