1. User id : 9786 Posted 3 years ago #
   

   Then, using a Veress needle through the umbilicus, we were able to insufflate the abdomen. All 4 quadrants were equally distended. Then, using a 10 Visiport, we were able to gain access to the intraperitoneal cavity under direct vision. Then, a 10 screw was placed near the umbilicus. Then, an additional 10/12 port was placed in the upper abdomen under direct vision. These were then secured to the abdomen using a suture. At this point, careful search of the abdomen demonstrated no obvious intraabdominal pathology. However, there was dense adhesions, which were taken down sharply. These were likely secondary to her laparoscopic cholecystectomy. At this point, we were able to reflect the left colon. The left kidney was visualized. The lower pole of the kidney was identified and defatted using electrocautery. At this point we were able to see the kidney and 3 biopsies were obtained using a biopsy instrument. These were then sent to Pathology for permanent analysis. We had the pathologist come into the room and they identified this as sufficient tissue for appropriate analysis. Then, the kidney was fulgurated using an argon beam.

2. SuperCoder Posted 3 years ago #
   

   From the Operative report it seems that the physician is performing a laproscopic nephrectomy (Then, the kidney was fulgurated using an argon beam.....). So as per that you can go with the code 50546. A kidney biopsy is inclusive in this case or not reported separately.

3. User id : 10290 Posted 3 years ago #
   

   I would code unlisted 50549..fulguration of the biopsy site??

4. SuperCoder Posted 3 years ago #
   

   Ok I think that it was not correct for me to say that a 50546 was performed. So in this case instead of reporting an unlisted code I think if we can code 49321 instead ???

5. User id : 10290 Posted 3 years ago #
   

   What is the appropriate code to report for a laparoscopic liver biopsy?

   AMA Comment:

   The CPT code set does not contain a code that specifically identifies this procedure. Therefore, it would be most appropriate to report code 47379, Unlisted laparoscopic procedure, liver.

   When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (eg, procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure and the time, effort, and equipment necessary to provide the service.

   I think the same rule applies here...I think code 49321 is for abdomen, peritoneum and omentum only.

6. User id : 9786 Posted 3 years ago #
   

   It was a kidney biopsy so I couldn't use 47379(liver) or 49321(abdomen, peritoneum, and omentum only). I think I'm stuck with the unlisted code 50549. Thanks for your help!!

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