General Surgery Coding Alert

Reader Question:

49321: Stick to Anatomic Site for Code Selection

Published on Thu Nov 17, 2011

Question: Can we use 49321 for a laparoscopic liver biopsy to avoid using an "unlisted" code?

Tennessee Subscriber

Answer: No, you should not report a laparoscopic liver biopsy using 49321 (Laparoscopy, surgical; with biopsy [single or multiple]). Instead, you should report the service using 47379 (Unlisted laparoscopic procedure, liver).

Here's why: 49321 is in the CPT subsection for "Abdomen, peritoneum, and omentum" (49000-49999). Because CPT provides specific codes in the "Liver" subsection (47000-47399), you should use one of those codes for a liver procedure. Because CPT® doesn't provide a specific laparoscopic liver biopsy code, you need to choose the unlisted procedure code.

Furthermore: The AMA has weighed in on this coding question in two CPT Assistant references. CPT Assistant Aug. 2006 indicates that the best code for the procedure is 47379, while Dec. 2007 also states that you should use 47379 for a laparoscopic wedge liver biopsy performed in addition to a laparoscopic cholecystectomy (47562-47564, Laparoscopy, surgical; cholecystectomy ...).

You should find no advantage in avoiding "unlisted" codes. Sometimes, those are the best code to describe a service, and you should use them unless a specific payer requires a different code for a particular procedure.

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