tci General Surgery Coding Alert - 2014 Issue 11

Reader Question: Account for Additional Lap Chole Work

Question: Our general surgeon performed a laparoscopic cholecystectomy with cholangiography. The surgeon noted that the gallbladder had lots of stones that intermingled with the small bowel loops and had extensive adhesions to the colon, which caused an open repair of injury to the colon. What is the correct coding for this case; can we bill for the colon repair with a separate code?  Nebraska Subscriber Answer: You should report the primary procedure as 47563 (Laparoscopy, surgical; cholecystectomy with cholangiography).  If the surgeon’s documentation clearly demonstrates that the creation of the intestinal hole was due to patient...

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