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General Surgery Coding Alert

Reader Questions:

Sometimes 'Unlisted' Is the Only Option

Published on Sat Nov 28, 2009

Question: We did a laparoscopic gastric wedge excisional biopsy and I cannot find a code for laparoscopic. Is there a better code to use than 43659? Georgia Subscriber Answer: You are correct that there is no code for the procedure you have described. You will have to go with the unlisted procedure code to report the laparoscopic gastric wedge excisional biopsy. As you suggested, 43659 (Unlisted laparoscopy procedure, stomach) is the proper code to report. Why: Unfortunately, coding for lap procedures hasn't kept up with technology. If no precise procedure or service code exists, you should report the service "using the appropriate unlisted procedure or service code," state the CPT Instructions for Use in the CPT manual. CPT includes unlisted-procedure codes to allow you to report procedures for which there is no specific CPT descriptor available. When there is an established CPT code that accurately describes the services your surgeon [...]
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