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General Surgery Coding Alert

Reader Question:

Use Inclusive Code for Whipple Resection

Published on Thu Nov 17, 2011

Question: Our surgeon performed a "Whipple Resection," which included creating an opening between the pancreas and jejunum. How should we code the procedure?California SubscriberAnswer: A complete op note would be necessary to answer this question with certainty, but the best code for the procedure you describe is likely 48150 (Pancreatectomy, proximal subtotal with total duodenectomyh, partial gastrectomy, choledochoenterostomy and gastrojejunostomy [Whipple-type procedure]; with pancreatojejunostomy). The alternate code for the complex Whipple resection is 48152 (... without pancreatojejunostomy). Because you describe creating an opening between the pancreas and jejunum, 48150 is the better code.Watch bundles: Whipple-type procedures involve removing several organs or parts of organs, so you need to exercise caution about bundling issues. For instance, the Correct Coding Initiative (CCI) lists cholecystectomy codes 47600-47620 as column 2 codes with 48150. The modifier indicator of "0" means that you cannot override the edit pair under any circumstances.
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