Camille Posted Thu 16th of May, 2019 12:15:24 PM
During a Laparoscopic Intra-Abdominal Biopsy (CPT 49321), the surgeon determined the appendix was thickened and abnormal, so performed a Lap Appendectomy as well. If it were open, i would report Add-On CPT 44955. How do I report the Lap Appendectomy? Can I code 49321 R19.00, +44979 K38.8 (Liken to 44955)? Thank you.
SuperCoder Answered Fri 17th of May, 2019 05:41:04 AM
Thank you for your question.
CPT code 44970 (Laparoscopy, surgical, appendectomy) would be appropriate for Lap Appendectomy and CPT code 49321 Laparoscopy, surgical; with biopsy (single or multiple) for intra-Abdominal Biopsy.
You can bill CPT code 49321 with R19.00 and 44970 with K38.8 if the documentation support both the procedures and medical necessity to perform both the procedures.
If the biopsy is related to diseased appendix, then intra-Abdominal Biopsy is considered included in primary procedure, CPT code 44970.
As per NCCI there is bundling between CPT code 44970 and 49321. Hence append modifier 59 with CPT code 49321 to unbundle the NCCI edit.
Hope this Helps!