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General Surgery Coding Alert

You Be the Coder:

Decide if Diagnostic Laparoscopy Stands Alone

Published on Tue Jun 14, 2011

Question: Sometimes for patients who have had prior abdominal surgeries, our surgeon will perform a diagnostic laparoscopy before inserting a peritoneal dialysis catheter to ensure adequate space for an effective peritoneal dialysis treatment. Can we bill the diagnostic lap in addition to the code for the catheter insertion?Pennsylvania SubscriberAnswer: You should not separately code a diagnostic laparoscopy immediately preceding the procedure to insert a peritoneal dialysis catheter. Whether the catheter insertion is laparoscopic or open, you'll have to bundle the diagnostic laparoscopy.Lap catheter insertion: You must always bundle diagnostic orexploratory laparoscopies into codes for surgical laparoscopy. That means if the surgeon performs a diagnostic laparoscopy (49320, Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) and laparoscopic catheter insertion (49324, Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter), you should only report 49324.Open catheter insertion: If the surgeon performs the 49320 [...]
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