General Surgery Coding Alert

Question: What does the term -separate procedure,- as used in CPT, indicate? Does this mean that I should always report such procedures separately?


New York Subscriber

Answer: CPT uses a -separate procedure- designation in code descriptors to identify procedures that the physician normally performs as a part of another, more extensive procedure, but which she may, on occasion, provide independently.

What not to do: Don't assume that a -separate procedure- designation means you can always report the code separately if the physician provides the service. In fact, a separate-procedure designation means that the procedure is bundled--and therefore not separately reportable -- anytime the physician provides a more extensive, related service.

Example: The physician performs laparoscopic jejunostomy (44186, Laparoscopy, surgical; jejunostomy [e.g., for decompression or feeding]) along with laparoscopic lysing of adhesions (44180, Laparoscopy, surgical, enterolysis [freeing of intestinal adhesion] [separate procedure]).

In this case, you cannot report 44180. The separate-procedure designation for this code means that it is bundled to the related, more extensive procedure (44186).

Technical and coding advice for You Be the Coder and Reader Questions provided by Marcella Bucknam, CPC, CCS, CPC-H, CCS-P, charge capture manager for the University of Washington Physicians.