Wiki Esophagogastrectomy / pancreaticoduodenectomy

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annettebec

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Does anyone have guidelines for charging out Esophagogastrectomy and/or pancreaticoduodenectomy

I have the information in the Pathology Coding Handbook; however, I am looking for more detail. In order to charge out an additional 88305, 88307 or 88309 ( the Handbook states that and additional 88305, 88307 or 88309 can be reported out - for a significant portion of the stomach or duodenum ) What length is significant? The handbook states the work required to examine it is equivalent to a biopsy, resection for tumor or resection for other than tumor. Are there a certain number of blocks. How is everyone determining whether to charge an additional 88305, 88307 or 88309? Any help appreciated
 

annettebec, I will reply to this post. Esophagogastrectomy is esophagus and stomach resection. Surgeon's don't do this operation unless we are dealing with tumor or cancer (both neoplastic processes). I would code the esophagus resection with 88309 and stomach resection with 88309 even if margins are negative here all day long.
Next, you have a pancreaticoduodenectomy that is a Whipple. We have head of pancreas resection (88309), duodenum (88309), gallbladder (88304), and bile duct (possible 88305). If partial gastrectomy I would have given it an 88309. Again, if margins are deemed "negative" we pray for patient's recovery. I will challenge any CPT assignment from any health insurance. We need negative margins and the reason the surgeon is taking out so many organs is to do so here and to help assist with the patient's care.
My opinion here with explanations on why.
Thank you for listening,
Dana​

 
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