General Surgery Coding Alert

Question: If my physician performs colectomy (44140) and takes down the splenic flexure, I can report add-on code 44139. If my physician does this same procedure laparoscopically (44204), how can I get reimbursed for takedown of the splenic flexure? Maryland Subscriber Answer: The code you-re looking for is +44213 (Laparoscopy, surgical, mobilization [take-down] of splenic flexure performed in conjunction with partial colectomy [list separately in addition to primary procedure]). CPT added this code in 2006 to accompany primary procedure codes 44204-44208. If the surgeon performs laparoscopic partial colectomy with takedown of the splenic flexure, you-d report 44204 (Laparoscopy, surgical; colectomy, partial with anastomosis) as the primary procedure, with add-on 44123 for the takedown. Claiming 44123 correctly will add 3.5 physician work relative value units -- or approximately $125 dollars on average, for Medicare payers -- to your reimbursement. The "open" equivalent of 44213 is, as you note, +44139 (Mobilization [take-down] of splenic flexure performed in conjunction with partial colectomy [list separately in addition to primary procedure]). CPT instructions direct you to use add-on 44139 only with primary codes 44140-44147 (Colectomy, partial-).