October 6, 2022 Question: A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case? Answer: Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours. *This response...
September 22, 2022 Question: What modifier is used to report a colostomy revision during the global period of the stoma creation? Answer: A modifier 78, return to the OR for a related procedure, in this case a complication of the creation, would be appended. *This response is based on the best information available as of...
September 8, 2022 Question: If mesh is placed for a laparoscopic hernia repair can an unlisted code be reported for the mesh placement? Answer: No. All laparoscopic hernia repair codes include mesh placement so it would not be appropriate to bill for mesh separately. *This response is based on the best information available as of...
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...
