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Laparoscopic Pyloroplasty
How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty?
Question:
How is a laparoscopic pyloroplasty reported? Can I use code 43800, Pyloroplasty?
Answer:
No, codes without the term laparoscopic in their description are intended as open codes and 43800 is an open code. There is no laparoscopic code for pyloroplasty so an unlisted code 43659 unlisted laparoscopic procedure, stomach, must be used.
*This response is based on the best information available as of 11/03/22.
Peritoneal Catheter Placement
I placed the peritoneal catheter for a neurosurgeon placing a V-P shunt. Do I code 49419, insertion of peritoneal catheter?
Question:
I placed the peritoneal catheter for a neurosurgeon placing a V-P shunt. Do I code 49419, insertion of peritoneal catheter?
Answer:
No, you are a co-surgeon with the neurosurgeon. Code 62223, creation of a ventriculo -peritoneal shunt, includesboth the neurosurgeon’s portion of placing the ventricular catheter and your portion of placing the peritoneal catheter. Both surgeonswill report 62223-62.
*This response is based on the best information available as of 10/20/22.
Co Surgeon or Assistant?
A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case?
Question:
A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case?
Answer:
Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours.
*This response is based on the best information available as of 10/06/22.
Choosing a Modifier with a Colostomy Revision
What modifier is used to report a colostomy revision during the global period of the stoma creation?
Question:
What modifier is used to report a colostomy revision during the global period of the stoma creation?
Answer:
A modifier 78, return to the OR for a related procedure, in this case a complication of the creation, would be appended.
*This response is based on the best information available as of 09/22/22.
Coding Mesh Placement in Hernia Repairs
If mesh is placed for a laparoscopic hernia repair can an unlisted code be reported for the mesh placement?
Question:
If mesh is placed for a laparoscopic hernia repair can an unlisted code be reported for the mesh placement?
Answer:
No. All laparoscopic hernia repair codes include mesh placement so it would not be appropriate to bill for mesh separately.
*This response is based on the best information available as of 09/08/22.
Billing for Intraoperative Injury
A major blood vessel was accidentally nicked while a general surgeon was performing a complex case. A vascular surgeon was called in to repair the blood vessel. Since they are different specialties, can the vascular surgeon bill for the repair, even though she is in the same group as the general surgeon?
Question:
A major blood vessel was accidentally nicked while a general surgeon was performing a complex case. A vascular surgeon was called in to repair the blood vessel. Since they are different specialties, can the vascular surgeon bill for the repair, even though she is in the same group as the general surgeon?
Answer:
Yes, if both surgeons are different specialties and designated with separate taxonomy number (General Surgery and Vascular Surgery are) then the vascular surgeon should bill for the repair.
*This response is based on the best information available as of 08/25/22.