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General Surgery Coding Alert

Reader Questions:

Watch for Specifics When Selecting Biopsy Code

Published on Thu Aug 21, 2008

Question: Our surgeon performed a diagnostic laparoscopy with biopsy for multiple liver lesions. Would 47370 be the correct choice for this procedure? Maryland Subscriber Answer: Code 47370 (Laparoscopy, surgical, ablation of one or more liver tumor[s]; radiofrequency) is likely not correct in this instance. The descriptor for 47370 stipulates ablation by radiofrequency -- while your question makes no mention of radiofrequency and stresses biopsy for study rather than outright destruction or removal (which is the effect of ablation). The surgeon can achieve the same results using cryosurgery (47381, Ablation ... cryosurgical), but this procedure doesn't fit your description any better. For a simple diagnostic laparoscopy, your best code choice is 49321 (Laparoscopy, surgical; with biopsy [single or multiple]). This code specifies "single or multiple," so you would report a single unit of 49321 regardless of the number of liver lesions the surgeon biopsies.
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