General Surgery Coding Alert
What Code for Lap Liver Bx?
Questions: The surgeon performed a laparoscopic cholecystectomy-and a liver biopsy at the same time. The biopsy occurs laparoscopically through the same incision as the lap chole. How should I report the liver biopsy? Illinois Subscriber Answer: Because this is a laparoscopic procedure, the obvious liver biopsy codes do not apply. Codes 47000 (Biopsy of liver, needle; percutaneous) and +47001 (- when done for indicated purpose at time of other major procedure) are both through-the-skin procedures, and 47100 (Biopsy of liver, wedge) describes an open liver approach. Frustratingly, the only laparoscopy codes in CPT's "liver" portion, 47370-47371, describe ablation of tumors and make no room for biopsy. This leaves only 47379 (Unlisted laparoscopic procedure, liver). There is a better choice: 49321 (Laparoscopy, surgical; with biopsy [single or multiple]). Although this code does not specify "liver," it falls under the general "laparoscopy" portion of CPT and clearly describes the procedure your surgeon performed. As CPT guidelines specify, you can (and should) save yourself the hassles of reporting an unlisted-procedure code unless "no specific code exists" to describe the procedure you wish to report. There are no bundling issues with 49321 and any of the laparoscopic cholecystectomy codes 47562-47564, so you should have no difficulty reporting both procedures (although multiple-procedure payment reductions will apply).
General Surgery Coding Alert
- Master Terminology for Whip-Smart Whipple Claims
Knowing if the surgeon joined the jejunum and pancreatic duct cuts your code selection in [...] - CPT 2008:
Modify Your Modifier Practices: Here's Why
The AMA works harder to convince you of documentation's importance If you-ve been less than [...] - CCI Update:
Increased Edit Pressure for Recto/Anal Surgeries
Wound repairs also face new bundles, but confirm what you-re already doing Version 13.3 of [...] - CMS Expands Medically Unlikely Edits for the New Year
A new modifier may be required for -unlikely- procedures The controversial medically unlikely edits (MUEs) [...] - CMS Paves the Way for Expanded Sedation Coverage
-Minimal- and -moderate- aren't the same, so check documentation carefully CMS has given the green [...] - You Be the Coder:
What Code for Lap Liver Bx?
Questions: The surgeon performed a laparoscopic cholecystectomy-and a liver biopsy at the same time. The [...] - Reader Questions:
If Cancer Is Verified, It's Not a Screening
Question: The surgeon performed colonoscopy "to examine the remainder of the colon" on a patient [...] - Reader Questions:
History Begins When Active Treatment Ends
Question: If a patient has been diagnosed with cancer, does a "history of cancer" diagnosis [...] - Reader Questions:
Medical Necessity Always Drives E/M Level
Question: I-m not clear on what CPT intends when it states I may report a [...] - Reader Questions:
Wound Culture Offers Many Options
Question: How should I bill for a wound culture? My physician may be seeing a [...]
