General Surgery Coding Alert

Question: What is, and how should I code for, -hand-assisted laparoscopy-?



Texas Subscriber

Answer: -Hand-assisted- laparoscopy describes a procedure in which the surgeon makes a slightly larger-than-usual incision. Prior to inserting the laparoscope, the surgeon inserts a device called a pneumo sleeve, which allows him to place one hand in the abdomen while maintaining the pneumoperitoneum required to perform a laparoscopic procedure.

Using the pneumo sleeve or -hand assist- does not alter coding for the procedure. As such, you should stick with the laparoscopic codes rather than turn to unlisted-procedure or -open- procedure codes when describing a hand-assisted laparoscopy.

Tip: The surgeon will use hand-assisted laparoscopy because of extenuating circumstances that make standard laparoscopy too difficult. This could indicate that modifier 22 (Unusual procedural services) may apply (although hand-assisted laparoscopy doesn't automatically mean you can report modifier 22).

You can get complete facts on modifier 22 by reading -Call on 22 if Your Surgeon Goes the Extra Mile- contained within this issue.