tci General Surgery Coding Alert - 2008 Issue 5

Reader Questions: Pay Attention to Approach for Pouch Repair

Question: How should I code repair of an ileoanal pouch fistula? New Mexico Subscriber Answer: The correct answer depends on the approach your surgeon uses to access the fistula. For a transperineal approach, report 46710 (Repair of ileoanal pouch fistula/sinus [e.g., perineal or vaginal], pouch advancement; transperineal approach). If the surgeon instead uses a combined transperineal-transabdominal approach, report 46712 (- combined transperineal and transabdominal approach). The approach distinction isn't trivial, either clinically or in terms of reimbursement. The "double" approach pays 36.32 physician work relative value units instead of just 17.01 physician work RVUs for the...

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