Code This Colon Resection Case
Question: Our surgeon performed a laparoscopic low anterior resection for diverticulitis. They also performed an ileocolic resection for Crohn’s disease during the same surgical session. The provider insists the procedures removed different areas of the colon and since each section had a different diagnosis, they should receive payment for both procedures. How do I report the procedures? Pennsylvania Subscriber Answer: Assign 44207 (Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)) to report the laparoscopic low anterior colon resection. The ileocolic resection could be reported with 44205 (Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy); however, this code is bundled with 44207. According to the National Correct Coding Initiative (NCCI) edits, 44205 is a column 2 code for 44207 and carries a modifier indicator of 0. The 0 modifier indicator means that Medicare doesn’t allow you to override the edit and unbundle the codes — even if the procedures take place during same operative session and on different body structures. Mike Shaughnessy, BA, CPC, Production Editor, AAPC
