tci General Surgery Coding Alert - 2013 Issue 5

Reader Question: Distinguish Laparoscopic, Open Codes

Question: How should we report the procedure when our surgeon performs laparoscopic closure of two intestinal fistulae? Nevada Subscriber Answer: You should report two units of 44238 (Unlisted laparoscopy procedure, intestine [except rectum]). You can generally report 44238x2, although some payers may prefer that you report each code on a separate claim line and list the second procedure with modifier 59 (Distinct procedural service). Although CPT provides a specific code for intestinal fistula closure, you can’t use it, because it describes an open procedure and you specified that the surgeon performed a laparoscopic procedure. The open code is...

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