tci General Surgery Coding Alert - 2005 Issue 9

READER QUESTIONS: 22 is an Option for Difficult Lap Chole

Question: During laparoscopic cholecystectomy, the surgeon encountered extensive adhesions. Can we report lysis of adhesions separately using 44200?Pennsylvania Subscriber Answer: No, you cannot claim 44200 (Laparoscopy, surgical; enterolysis [freeing of intestinal adhesion] [separate procedure]) in addition to the lap chole (such as 47562, Laparoscopy, surgical; cholecystectomy) because the National Correct Coding Initiative bundles the procedures. And the use of "separate procedure" in the descriptor for 44200 means that you can only report lysis of adhesions separately if it is the only procedure the surgeon performs.If, however, the surgeon spent significant additional time lysing adhesions (in other words...

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