Wiki Intraoperative consult/Lap Appy

[rsboggs]

I have read and posted about this before, but cant seem to find much on it now.

Our GS OFTEN gets called into a diagnostic lap being performed by an OB/GYN to do appendectomies.

Usually (75%) the pathology reports come back appendcities, fibrous obliteratioin of the lumen, etc. etc. and the procedure isnt done "Just because".

My surgeon usually adds 1 or 2 additional ports and removes the appendix. He does not do any closing or follow up care. I have been billing these as 44970/52.

What is your thinking on these types of cases? I see one reply to another thread I had that says just to report the code with no modifier, and I have also seen where using modifier 54 is recommended.

I dont feel modifier 62 is correct as they are not doing certain parts of a procedure each, they are doing completely different procedures.

Any input would help because I am totally second guessing myself and I have 4 that need billed soon

Thanks for all input ahead of time!

 

[tcooper@nmhs.net]

When I bill this procedure if it is Laparoscopic I use the 44970 with no moidier. I agree with you it should not be a 62. I hope you got reimbursement for the Lap Appendectomies. Have a good day.
Teresa Cooper, CGSC

 

[FTessaBartels]

Co-surgeon

Without reading all the notes, it's hard to say what exactly your surgeon should code.

But one thing clearly stands out. In your post you state that he doesn't close or perform any follow-up services. Clearly this needs a -54 modifier ... he didn't do any pre-operative work or post-operative work, so should clearly code with a -54 modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC