Viola Posted Mon 21st of June, 2010 15:36:45 PM
I am already billing for rrp w/bi pelvc lymph node disection(55845). However, could I bill additional codes based on the following op note addendum?
Addendum: The left neurovascular bundle was markedly adherent to the rectum, as if the patient had a hematoma following the biopsy. In freeing it up, there was a capsular incision. I then went back and took tissue off the neurovascular bundle to make certain that all tissue that would have been present at the capsular incision was completely excised.
SuperCoder Answered Tue 22nd of June, 2010 07:06:57 AM
Per the code descriptor, 55845 is a very extensive surgery; it includes removal of external iliac, hypogastric, and obturator lymph nodes at the time of RRP + bilateral pelvic lymphadenectomy. The dissected tissues, along with the prostate gland (with capsule intact), the seminal vesicles, and the portions of the vas deferens in the area are removed by freeing the prostate from the area. It seems to me that the above mentioned part is included in the actual surgical procedure and it's not required to bill separately.