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Reporting Bowel Left in Discontinuity
What codes are reported if the bowel is left in discontinuity as part of damage control surgery?
Question:
What codes are reported if the bowel is left in discontinuity as part of damage control surgery?
Answer:
Since the bowel is resected but an anastomosis is not performed, report the appropriate bowel resection code with a 52 modifier for reduced services.
*This response is based on the best information available as of 06/14/18.
Coding 19120 vs 19301
What’s the difference between code 19120, breast mass excision and 19301, partial mastectomy/lumpectomy?
Question:
What’s the difference between code 19120, breast mass excision and 19301, partial mastectomy/lumpectomy?
Answer:
Both codes describe the excision of a lesion in the breast. Code 19120 is describes the excision or open removal of a cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion.
In contrast, code 19301 also describes removal of a lesion by performing a partial mastectomy, for example a lumpectomy, tylectomy, quadrantectomy, or segmentectomy.However, this code requires the necessity and documentation of attention to the removal of adequate surgical margins surrounding the breast mass or lesion.
*This response is based on the best information available as of 05/03/18.
Right Colectomy and Small Bowel Resection
The surgeon did a right colectomy and also documented a resection of the ileum. Is this billed separately as a small bowel resection?
Question:
The surgeon did a right colectomy and also documented a resection of the ileum. Is this billed separately as a small bowel resection?
Answer:
No. The resection of the ileum and anastomosis of the new end of the ileum (the neoterminal ileum) to the remaining colon (an ileocolostomy) is included in the code; 44160 for open and 44205 if performed laparoscopically.
*This response is based on the best information available as of 03/29/18.
Coding a Skin or Nipple Sparing Mastectomy
What is the appropriate code for a complete skin sparing or complete nipple sparing mastectomy?
Question:
What is the appropriate code for a complete skin sparing or complete nipple sparing mastectomy?
Answer:
The code for a mastectomy described as complete skin sparing or complete nipple sparing mastectomy is 19303.
*This response is based on the best information available as of 04/19/18.
Breast Cyst Aspiration
The surgeon did a fine needle aspiration of two cysts in the same breast without any imaging. Is this billed once or twice?
Question:
The surgeon did a fine needle aspiration of two cysts in the same breast without any imaging. Is this billed once or twice?
Answer:
Fine needle aspiration of a breast cyst is reported per cyst. In this scenario, code 10021 with 2 units or 10021 and a second 10021 with a 59 or XS modifier as directed by your payor.
The fine needle aspiration codes are shown below.
Fine Needle Aspiration (FNA)
|
CPT Code |
Description |
|
10021 |
Fine needle aspiration; without imaging guidance |
|
10022 |
with imaging guidance |
Global Period for both codes – XXX*XXX means the concept of global period does not apply
*This response is based on the best information available as of 02/01/18.
Laparoscopic Pyloroplasty Coding
How is a laparoscopic pyloroplasty reported?
Question:
How is a laparoscopic pyloroplasty reported?
Answer:
There is no current CPT code laparoscopic pyloroplasty, only an open code. An open code may not be used if a procedure is done laparoscopically. An unlisted code must be used. In this case, use code 43659, unlisted laparoscopic procedure, stomach.
*This response is based on the best information available as of 01/18/18.