coding advice

Coder-To-Coder Forum

coding advice

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healingtouch 06-23-2010, 3:29 PM
I am new to this - still learning and wanted advice on this one.

Dr did
1) lap chole
2) lap lysis of adhesions, converted to open for lysis of adhesions
3)repair of iatrogenic small bowel injury.

how would you bill this one?

Re: coding advice

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Barb S. 07-01-2010, 3:17 PM
Code the lap chole. Lysis of adhesions is usually inclusive, though you can add a 22 modifier to the lap chole procedure code.

Re: coding advice

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Mary1974 07-16-2010, 2:06 PM
I believe you gave the wrong advice here. You must specify that the coding would be lap converted to surg which codes to cpt 47600. Both the CPT and ICD codes are different for lap chole vs. a lap chole converted to open. You also would not use the 22 mod because the lysis of adhesions is inclusive of the procedure.

Mary Caparelli CCS

Re: coding advice

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born 2 code 08-02-2010, 5:44 AM

Mary,

I have few questions for you, hope you don't mind to clarify me.

Lap chol is already done, so how to get reimbursement for that skill.

During termination of the procedure, the Doc is forced to do adhesiolysis, and the only way to get reimbursed for open enterolysis is to add Mod.22 as this procedure is inclusive.

If you code only 47600, you are not reporting the usage of Laparoscope and you are changing the entire type of procedure.

As Barb told you need to charge for Lap chol and use Mod.22 and produce the Medical Records for medical necessity.

Chris CPC, CCS

Re: coding advice

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Mary1974 08-02-2010, 7:35 AM
When a laparoscopic procedure is converted to open, you code the procedure as open. If you add a mod 22 to a procedure that is inclusive of another, you are overcoding. You would not need to code the laparoscopic portion of the procedure because you code the procedure to the fullest extent to which it was completed in this case, it was laparoscopic converted to open.

Re: coding advice

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born 2 code 08-04-2010, 2:02 AM
Ok thanks.