Wiki Billing for repair of injury sustained during another procedure

[sacook]

Can someone direct me to where I can find written guidelines that state if a provider can bill for repair of an injury sustained during another procedure. My specific case is a lap appendectomy with the appendix behind the cecum and adherent to the small intestine. During dissection the cecum sustained a 2 cm enterotomy. There was no leakage. Is this repair billable?

I would greatly appreciate some guidance and something I can show my provider.

Thank you.

 

[cgaston]

CMS addresses this issue in the 40000 section of the NCCI Edit Manual which you can download from here:
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html


Chapter VI
Surgery: Digestive System
CPT Codes 40000 - 49999


10. If an iatrogenic laceration/perforation of the small or large intestine occurs during the course of another procedure, repair of the laceration/perforation is not separately reportable. Treatment of an iatrogenic complication of surgery such as an intestinal laceration/perforation is not a separately reportable service.

 

[sacook]

Thank you so much.