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cpt help

Lynn Posted Mon 31st of October, 2016 07:19:12 AM
My doctor did LAPAROSCOPIC LEFT SALPINGO-OOPHORECTOMY and an APPENDECTOMY. There was also a BIOPSY OF FALCIFORM LIGAMENT. What is the CPT code for the biopsy of falciform ligament?
SuperCoder Answered Tue 01st of November, 2016 02:58:28 AM

Please provide some more details and approach of procedure which is used for BIOPSY OF FALCIFORM LIGAMENT. 

Lynn Posted Tue 01st of November, 2016 07:46:05 AM
A section of the falciform ligament was excised and sent for frozen section. The mesoovarium was cauterized and divided. The fallopian tube was cauterized and divided at the cornua. The uteroovarian ligament was cauterized and divided. The ovary was placed in the large endocatch bag and brought to the umbilical skin incision. The cystic mass was drained and removed from the abdomen entirely within the bag. This was sent for frozen section.
SuperCoder Answered Wed 02nd of November, 2016 09:17:14 AM

As per NCCI edits if  biopsy performed at the time of another more extensive procedure (e.g., excision, destruction, removal) is separately reportable under specific circumstances.

  • If the biopsy is performed on a separate lesion, it is separately reportable. This situation may be reported with anatomic modifiers or modifier 59(XU, XS, XP).

 

  • If the biopsy is performed on the same lesion on which a more extensive procedure is performed, it is separately reportable only if the biopsy is utilized for immediate pathologic diagnosis prior to the more extensive procedure, and the decision to proceed with the more extensive procedure is based on the diagnosis established by the pathologic examination.

 

  • The biopsy is not separately reportable if the pathologic examination at the time of surgery is for the purpose of assessing margins of resection or verifying resectability.

 

  • If a biopsy is performed and submitted for pathologic evaluation that will be completed after the more extensive procedure is performed, the biopsy is not separately reportable with the more extensive procedure.

 

  • If a single lesion is biopsied multiple times, only one biopsy code may be reported with a single unit of service. If multiple lesions are non-endoscopically biopsied, a biopsy code may be reported for each lesion appending a modifier indicating that each biopsy was performed on a separate lesion. For endoscopic biopsies, multiple biopsies of a single or multiple lesions are reported with one unit of service of the biopsy code. If it is medically reasonable and necessary to submit multiple biopsies of the same or different lesions for separate pathologic examination, the medical record must identify the precise location and separate nature of each biopsy

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