August 25, 2022 Question: A major blood vessel was accidentally nicked while a general surgeon was performing a complex case. A vascular surgeon was called in to repair the blood vessel. Since they are different specialties, can the vascular surgeon bill for the repair, even though she is in the same group as the general...
August 11, 2022 Question: My surgeon was called into a laparoscopic operation that was already underway, to perform extensive lysis of adhesions. Does he need to use a modifier 52 because the patient was already “opened”, or can we just bill for 44180 Laparoscopic lysis of adhesions? Answer: You would bill for 44180 without a...
July 28, 2022 Question: The surgeon performed an open colectomy and found a tear in the mesentery close to the incision, 44850 Suture of mesentery is listed as a “separate procedure”, does that mean we can bill for it separately in addition to the colectomy? Answer: No, codes designated as a “separate procedure” are intended...
July 14, 2022 Question: Our surgeon insists on billing for 49002 reopening of a recent laparotomy and a 44005 lysis of adhesions, since the case is complicated because the laparotomy was only 60 days ago. Can he bill for both in any circumstance? Answer: Although this was a reopening of a recent laparotomy, lysis of...
June 30, 2022 Question: My coder just told me about the new guidelines for 2021 office visit codes. She said I no longer have to document a History. This doesn’t seem right to me. Answer: You are wise to ask because that’s not exactly true. It is correct that the History will no longer be...
June 16, 2022 Question: While performing a cholecystectomy a tear in the small bowel was made during extensive lysis of adhesions. Can repair of this injury be billed in addition to the cholecystectomy? It was unavoidable since it was the consequence of the extensive lysis required? Answer: Although the tear was unavoidable, the repair would...
June 2, 2022 Question: The surgeon did a robotic/laparoscopic cholecystectomy and cholangiogram with ICG and firefly identification of biliary anatomy. He billed a 47563. Can he can bill separately for the icy green and firefly dye? Answer: Billing for indocyanine (ICG) or Firefly TM fluorescence is bundled into 47563 laparoscopic cholecystectomy with cholangiogram and is...
May 19, 2022 Question: The new guidelines that are coming out in 2021 for all types of E/M services, right? Answer: No. The new guidelines are for office/outpatient visit codes only (99202-99215). You will still need to use the current guidelines for all other E/M services, even consultations in the office. *This response is based...
May 5, 2022 Question: We did an abdominal fat pad biopsy for primary cutaneous Amyloidosis. Would 49180 or 11104 be the appropriate code for this? Answer: 49180 is for a core sample within or behind the abdominal cavity. If the core biopsy is documented down to the subcutaneous fat pad only, this is coded as...
April 21, 2022 Question: The surgeon described the procedure as a ‘hand assisted laparoscopy”. He brought part of the bowel outside of the body for evaluation. Does this convert the procedure to open? Answer: Mobilizing the bowel outside the body (extracorporeally) during a laparoscopic procedure does not convert the procedure to open, it is still...
