Wiki billing for 44120 and 44121

[riverloverjen38@yahoo.com]

Quick question. Physician performed a small bowel resection with anastomosis. After checking for a leak, a leak was found so the small bowel anastomosis was resected and another anastomosis was performed. I know to bill the 44120 but the physician wants me to also bill 44121. Is this correct? I think it should just be the 44120.

 

[kaybrowning]

Quick question. Physician performed a small bowel resection with anastomosis. After checking for a leak, a leak was found so the small bowel anastomosis was resected and another anastomosis was performed. I know to bill the 44120 but the physician wants me to also bill 44121. Is this correct? I think it should just be the 44120.

4412Ø Enterectomy, resection of small intestine; single resection and anastomosis
44121 Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure)

you stated in your question that another anastomosis was performed.

 

[csperoni]

I think it depends on whether there was an additional leak, or the first anastomosis didn't get the job done. Just like you can't bill to repair your own error, I would not bill for a 2nd anastomosis if the first was unsuccessful. If there were indeed 2 separate repairs then both would be justified (but that does not seem like the case here).
I like analogies - if pt went to the doc with a 2.3cm lac on forearm and it was sutured (simple closure) but the sutures didn't adequately close the wound and he removed & then resutured, you wouldn't bill for 4.6cm or 2 repairs. If patient went with 2 separate forearm wounds, first 1.8cm and second 2.8cm both simple closure, THEN you would bill for 4.6cm.
I hope that better explains where I'm coming from.