tci General Surgery Coding Alert - 2013 Issue 1

Reader Question: Make Sure Surgical Approach Matches Code

Question: How should we bill a laparoscopic pyloromyotomy? In general, if our surgeon performs a laparoscopic procedure that doesn’t have a specific code, should we use the open-code for the procedure? California Subscriber Answer: You should bill the laparoscopic pyloromyotomy as 43659 (Unlisted laparoscopic procedure, stomach). You should not use the open code for the procedure (43520, Pyloromyotomy, cutting of pyloric muscle [Fredet-Ramstedt type operation]). General rule: You should never use a code for a surgical procedure if the approach doesn’t match. That is, don’t use an open code for a laparoscopic procedure, or vice versa...

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