Wiki Help! 00790 v 00840 for anesthesia for a hemicolectomy

TanyaJ

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We are getting a bunch of denials from a certain carrier because they state we should be using 00840 instead of 00790 for hemicolectomy/colectomy.

One specific case the mid transverse colon is where the tumor was and that is where the primary work was done. The only mention of the sigmoid is when "the white line of Toldt was taken all the way down into the sigmoid" to free the area up.

The ASA crosswalk points to 00790 and only use 00840 when work was exclusively done on sigmoid or rectum.

We have never had this issue before. Are we missing something? Has anyone else had this problem recently and how did you prove your case?
 
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