August 17, 2023 Question: Can I report code 47563 when indocyanine green (ICG) dye is injected and then I use minimally invasive fluorescent imaging to view structures during dissection? Answer: No, it would not be correct to report code 47563 for this clinical scenario. Instead report code 47562, Laparoscopy, surgical; cholecystectomy. Although evaluation using fluorescent...
August 3, 2023 Question: The patient had extensive adhesions that had to be lysed. Is it appropriate to report 44005, enterolysis (freeing of adhesion), along with the code for the primary surgery? Answer: No, 44005 enterolysis (freeing of adhesions) for an open procedure and 44180, Laparoscopic enterolysis, are both designated as “separate procedures.” They are...
July 20, 2023 Question: How is a right colectomy with a loop ileostomy reported? Answer: A loop ileostomy with a right colectomy is reported with 44160 (open) or 44205 (laparoscopic) and creation of an ileostomy; code 44130 (open) or code 44187 laparoscopic. This reflects the additional work of creating the external opening; the ileostomy. Source:...
July 6, 2023 Question: The surgeon performed a laparoscopic repair of an initial strangulated ventral hernia and a laparoscopic repair of an inguinal hernia on the same day. Can the surgeon bill for both procedures? Answer: Yes, both procedures can be reported with codes 49592, 49594, or 49596, depending on size, and 49650, Laparoscopy, surgical;...
June 22, 2023 Question: I’m confused as to why 19120, excision of breast mass requires different incisions to bill two excisions, when 19125 and +19126 removing two breast masa with a wire or marker does not require separate incisions. Answer: Code 19120 is a primary case and as such includes the exposure ( opening), the...
June 8, 2023 Question: When choosing the level of E&M we are confused about the History and Exam. If we choose a level of E&M based on time, does this time count toward total time, or is it only time spent on MDM? Answer: When choosing a level of E&M based on time, CPT identifies...
May 25, 2023 Question: We have a patient with 2 commercial payers (BCBS and Cigna). A consultation code was submitted to BCBS, and they paid according to our contract. However, Cigna is refusing to process the claim since they no longer pay for consult codes. Am I allowed to change the CPT code and rebill...
May 11, 2023 Question: I placed a non-biological implant for abdominal soft tissue reinforcement. Can this be coded as +15777? Answer: No. Code +15777 is reported specifically for a biological implant for soft tissue reinforcement implant in breast or trunk only. Code +0437T, a Category III code, is reported for implantation of a nonbiologic or...
April 27, 2023 Question: If a patient undergoes an open cholecystectomy and has a reducible umbilical hernia repaired during the same operative session, through separate incisions, can both be reported? Answer: Yes, if both procedures were performed through separate incisions both may be reported. Conversely, if both were repaired through the same incision, only the...
April 13, 2023 Question: If a cholangiogram was performed by the surgeon during a cholecystectomy, but the radiologist interprets it, is 47563, Laparoscopy, surgical; cholecystectomy with cholangiography still appropriate? Answer: Yes, the codes “with cholangiogram” are valued for intraoperative physician work, not the interpretation. *This response is based on the best information available as of...
