Category: CC-General Surgery

Coding a Hand Assisted Laparoscopy
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Coding a Hand Assisted Laparoscopy

April 21, 2022 Question: The surgeon described the procedure as a ‘hand assisted laparoscopy”. He brought part of the bowel outside of the body for evaluation. Does this convert the procedure to open? Answer: Mobilizing the bowel outside the body (extracorporeally) during a laparoscopic procedure does not convert the procedure to open, it is still...

Billing for a Wound Vac
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Billing for a Wound Vac

March 10, 2022 Question: Can you bill for a wound vac on a surgical incision if the patient has a history of incision infections to help prevent this? Answer: The AMA published clarification on wound vac billing in the October 2021 CPT Assistant. Negative pressure wound therapy (97605-97606) is considered billable for both open and...

Using Modifier -22 for Adhesiolysis
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Using Modifier -22 for Adhesiolysis

February 24, 2022 Question: My provider indicated that it took her an additional 80 minutes during a surgery to perform adhesiolysis. Is documentation of the time sufficient? Answer: Although time (specific minutes) should always be indicated in the operative note, the provider must also give the reason why the lysis took longer (what complicated this...

Billing E/M Visits During the Global Period
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Billing E/M Visits During the Global Period

February 10, 2022 Question: Can I bill different diagnosis codes for conditions/problems when seeing a patient in the hospital after surgery, but during the stay of a major surgery? Answer: It depends. You cannot bill for related issues or known complications that arise from the surgery, but you can bill for unrelated conditions/problems with proper...

Coding a Diverting Ileostomy with a Low Anterior Resection/Low Pelvic Anastomosis Partial Colectomy
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Coding a Diverting Ileostomy with a Low Anterior Resection/Low Pelvic Anastomosis Partial Colectomy

January 27, 2022 Question: Instead of a colostomy as described in the laparoscopic CPT codes 44208 or the open code, 44146, my doctor does a diverting ileostomy.  We have been billing the primary codes 44145 or 44207 and adding the ileostomy code, 44187 if laparoscopic or 44310 if open.  Is that correct? Answer: Partial colectomy...

Intraoperative ICG Dye Angiography
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Intraoperative ICG Dye Angiography

December 30, 2021 Question: Can we bill the 92242 for the indocyanine green injection intraoperatively, for example to assess perfusion after a colectomy or other abdominal procedure? Can we bill for the injection using 15860? Answer: No, this service is included in primary surgery and not separately reported. *This response is based on the best...

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