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Wiki can a 49320 and 43830 be billed together

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dsandiego

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Hi Everyone!

Does anyone know if a 49320 laparoscopy can be billed with a 43830 gastrostomy? I'm a fairly new coder, and a payer is denying a claim because the codes are inclusive. I can't seem to find it anywhere in my CPT book that states why these two codes CANNOT be billed together. If anyone has knows the answer i'll be much appreciative.

thank you
 
Agreed, you would not bill these together under normal circumstances, e.g. if performed at the same session. 49320 carries the 'separate procedure' designation in CPT - you'll find the guidance on this in the Surgery Guidelines section of the CPT book: "codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is considered an integral component."
 
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