General Surgery Coding Alert

Question: A general surgeon was performing a gallbladder removal through the scope and called me in to evaluate an adhesion between the fallopian tube and the abdominal wall. I scrubbed in and, using the existing ports, lysed the adhesion. I visited the patient twice during the post-operative period. How do I code this?

SuzAnne Palmer, MD
Milledgeville Ob/Gyn, Ga.

Answer: The correct billing would be 56304 (laparoscopy, surgical; with lysis of adhesions [salpingolysis, ovariolysis] [separate procedure]) with modifier -52 (reduced services) attached, says Susan Callaway-Stradley, CPC, CCS-P, a coding and reimbursement specialist and educator in North Augusta, S.C. You probably will be required to submit documentation as well so the carrier can determine how much you should be paid, Callaway-Stradley says. Anytime a surgeon doesnt perform a procedure in its entirety, the carrier should be notified, she adds. Although 56304 is an old code that was changed in CPT 2000 to 58660, the new code applies only to procedures performed on or after Jan. 1, 2000.

The general surgeon, meanwhile, would bill for the laparoscopic cholecystectomy using CPT code 56340 (laparoscopy, surgical; cholecystectomy [any method]) or 56341 (cholecystectomy with cholangiography). In CPT 2000, the new codes are 47562 and 47563, respectively.