tci Medicare Compliance & Reimbursement - 2008 Issue 37

Reader Question: Here's How To Code For Conversion To

CCI bundles laparoscopic portion into open code. Question: My doctor did a laparoscopic cholecystectomy with intraoperative cholangiogram. He then converted to an open procedure to do a common bile duct exploration followed by a choledochoscopy. He also performs a T-tube cholangiogram, and placed an ON-Q pain catheter. How should I code this? Answer: You shouldn't report both 47563 (Laparoscopy, surgical; cholecystectomy with cholangiography) and 47610 (Cholecystectomy with exploration of common duct) because you'd be trying to get reimbursement twice for the cholecystectomy. Since Correct Coding Initiative (CCI) bundles the bile duct exploration into the cholecystectomy with cholangiography, and the...

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