AHA Coding Clinic® for HCPCS - 2024 Issue 4; Ask the Editor

Correction: Transanal Minimally Invasive Surgery (TAMIS)

A patient with history of resection of malignant polyp presents for excision of a T1 vs T2 tumor at the same area. Under general anesthesia a transanal rectal excision with a transanal minimally invasive surgery (TAMIS) platform was performed. A transanal GelPort® was placed, and trocars were placed through the GelPort®. Electrocautery was used to begin the dissection down to muscular layer. The resection extended through the full thickness of the rectum. The polypectomy site was excised in its entirety using the previously marked circumferential margins. The specimen was handed off to pathology and the rectal defect was closed with sutures. This issue was previously addressed in Coding Clinic for HCPCS Third Quarter 2019 which advised to assign CPT code 0184T. However, the title of the code states that the procedure is performed via an endoscopic microsurgical approach, which is supported by CPT Assistant February 2018. Additionally, the code descriptor has a parenthetical note of “(ie TEMS).” In CPT when “ie” is used in a parenthetical it means only the terms listed in the parentheses are included. We believe a TAMIS is not analogous to a TEMS. We are asking Coding Clinic to revisit this advice. What is the correct code assignment for an endoscopic TAMIS transanal excision without the use of an endoscopic microsurgical device? ...

To read the full article, sign in and subscribe to the AHA Coding Clinic® for HCPCS.

Thank you for choosing Find-A-Code, please Sign In to remove ads.