Category: General Surgery

Billing for Intestinal Tear During Enterostomy Closure
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Billing for Intestinal Tear During Enterostomy Closure

June 16, 2022 Question: While performing a cholecystectomy a tear in the small bowel was made during extensive lysis of adhesions. Can repair of this injury be billed in addition to the cholecystectomy? It was unavoidable since it was the consequence of the extensive lysis required? Answer: Although the tear was unavoidable, the repair would...

Billing for ICG Dye
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Billing for ICG Dye

June 2, 2022 Question: The surgeon did a robotic/laparoscopic cholecystectomy and cholangiogram with ICG and firefly identification of biliary anatomy. He billed a 47563. Can he can bill separately for the icy green and firefly dye? Answer: Billing for indocyanine (ICG) or Firefly TM fluorescence is bundled into 47563 laparoscopic cholecystectomy with cholangiogram and is...

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...

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