Part B Insider (Multispecialty) Coding Alert

If the surgeon converts a lap chole to an open procedure, be sure to include V64.41 (Laparoscopic surgical procedure converted to open procedure) as a secondary diagnosis. Using V64.41 does not affect the primary diagnosis (for instance, 575.0, Acute cholecystitis), which should remain the same regardless of the surgeon's surgical approach.

You should also use additional diagnosis codes to describe the conditions that lead to the decision to change from the laparoscopic to the open approach. These conditions could include adhesions, abscess or others.