Wiki DX Lap, median pancreatectomy with Rounx-en-Y pancreatic jejunenostomy...

[cedwards]

We are going to be performing a procedure on a patient whose insurance we are not par with. We are in the process of negotiating a fee with the insurance company. Here is the scenario of what the provider plans on performing. Please help me choose the CPT codes...

Diagnostic laparoscopy, then a median pancreatectomy with a Roux-en-Y pancreatic jejuenostomy and possible subtotal pancreatectomy and splenectomy. Diagnosis is cystic neoplasm of the pancreas.

Any help would be greatly appreciated.

Thanks!

 

[lavanyamohan]

Hello,
A diagnostic laparascopy with a Roux-en-Y pancreatic jejunostomy may not be paid on the same date of service.
Also, a subtotal pancreatectomy encompasses a median pancreatectomy and these too should not be billed for the same DOS.
Suggestion-
If you want both the jejunostomy and splenectomy billed, it is safe to include the type of neoplasm-whether benign or malignant.
The reason is, for benign neoplasm only a median pancreatectomy and probably the diagnostic laparoscopy will end up getting paid.