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CPT code for the surgery

Lina Posted Tue 15th of September, 2015 10:20:25 AM

The Doctor had the procedure done in the office: "Dilation of anal canal (stricture of rectum)", but under local anesthesia, cause the patient is at rick to get the general anesthesia. The only code I came up with is 45910,which its exactly describes what was done except under general anesthesia. What would be the best way to code this? Maybe modifiers? Or any other codes?

SuperCoder Answered Wed 16th of September, 2015 05:39:12 AM

Well, CPT 45910 will not go with the local anesthesia. Unlisted CPT code 45999 seems appropriate to bill for the procedure. Always attach the operative report when billing unlisted procedure code with the claim form to avoid deduction of the dollar value. Hope it helps!

Lina Posted Mon 28th of December, 2015 14:35:04 PM

Hi I got a denial for CPT code 45999 with (operative report) stating that : "Unlisted Procedure rebill with descriptive code" (CE)
What would be your suggestions?

SuperCoder Answered Tue 29th of December, 2015 07:05:29 AM

There is no such specific code for the procedure described instead of unlisted CPT code i.e. 45999. It is suggestible to re-submit the claim form with below mentioned suggestions. When reporting an "unlisted procedure code" or a "not otherwise classified" (NOC) code, include a narrative description in item 19 if a coherent description can be given within the confines of that box. This is a required field. There are high chances of return of claim as un-processable, if an "unlisted procedure code" or a NOC code is indicated in item 24d, but an accompanying narrative is not present in item 19 or on an attachment. So, check both the fields in the form (19 and 24d) and re-submit it.

Lina Posted Tue 29th of December, 2015 12:25:45 PM


SuperCoder Answered Wed 30th of December, 2015 00:19:54 AM

Happy to help.

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