Cristina Posted Tue 07th of July, 2015 16:51:07 PM
What would be the best way to code a diagnostic laparoscopy in conjuction with the neuro surgeon placing a shunt?
SuperCoder Answered Wed 08th of July, 2015 02:03:21 AM
If a laparoscopy is performed as a “scout” procedure to assess the surgical field or extent of disease, it is not separately reportable. If the findings of a diagnostic laparoscopy lead to the decision to perform an open procedure, the diagnostic laparoscopy may be separately reportable.
Cristina Posted Thu 09th of July, 2015 13:07:23 PM
Laparoscopy with reinternalization of ventriculoperitoneal shunt
My surgeon did the laparoscopy portion of the procedure and i think he did more then "scouting". Please read his part of the procedure and let me know. Thank you!!
Description of procedure;
I reopened her previous infraumbilical incision and dissected down to the abdominal wall fascia. I removed the suture that had been previously placed to close the fascial defect from the previous laparoscopy. I inserted a 5mm step trocar throught this opening and created a co2 pneumoperitoneum. Visualization of the peritoneal cavity showed no evidence fo trocar injury. there were mild adhesions noted, mainly in the right side of the abdomen. The left side of the abdomen was fairly clear of adhesions. Dr A then completed her work the the ventricular portion fo the VP shunt. She then tunneled the catheter down to a location on the left upper quadrant fo the abdomen where i had a clear view of the peritoneal cavity and would be a good choice for the location to internalize the shunt. At this point, a small incision was made and i placed a needle and then a guidewire through the abdominal wall under direct visualization. I then removed the needle and followed over the wire with a dilator and peel away sheath. I removed the guidewire and dilator, leaving the peel away sheath intact. The peritoneal portion of the ventriculoperitoneal shunt was then passed through the peel away sheath into the peritoneal cavity and eventually the peel away sheath was slowly removed. The catheter was noted to function properly within the peritoneal cavity. The co2 pneumoperitoneum was released and the umbilical trocar was removed.
SuperCoder Answered Fri 10th of July, 2015 04:24:49 AM
When two surgeons work together as primary surgeons performing distinct parts of a procedure, each surgeon should report the co-surgery once using the same procedure code and report his/her distinct operative work by adding modifier 62 to the CPT code.
Cristina Posted Mon 13th of July, 2015 18:11:39 PM
So in this case the primary surgery was coded as 62230-62. But my surgeon is wanting to know if he can bill for a diagnostic laparoscopy and what would be the best code to use. Thank you
SuperCoder Answered Tue 14th of July, 2015 01:20:55 AM
Yes, you can bill for diagnostic laparoscopy. CPT code 49320 is the code that your surgeon should bill.