Gastroenterology Coding Alert

Question: Our gastroenterologist has been using the Secca System to treat several fecally incontinent patients. Since CPT has no code for Secca, we have had some trouble on the reimbursement end. What is the best way to report the Secca System? Arizona Subscriber Answer: Having been introduced in 2002, the Secca System is still gaining acceptance among payers as a legitimate outpatient procedure for treatment of fecal incontinence. Unfortunately, that means that coders who want to file claims for Secca System treatment must report 46999 (Unlisted procedure, anus).

No one likes to report unlisted-procedure codes, but they exist for situations when there is no other option -- and there are no other options in this case.

Remember: No matter how thorough you are, don't be surprised if you have to appeal to get paid using this unlisted-procedure code.

To increase your chances of initial reimbursement, call your private payers before filing a Secca claim and ask what they want to see on a claim.

The payer will probably tell you to remember to attach documentation of other, more conventional attempts at treatment for fecal incontinence, such as using fiber or biofeedback.

No private carrier is likely to pay for Secca if some other treatments haven't been tried first.

The payer will also tell you to include proper diagnosis codes for fecal incontinence -- such as 307.7 (Encopresis [continuous] [discontinuous] of nonorganic origin) and 787.6 (Incontinence of feces).