Question Hemidiaphragm Biopsy at the same time of a right hemicolectomy (Laparoscopic)

mfournier

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Hello Everyone:

Has anyone ever billed for this type of biopsy?? All I'm coming up with is an unlisted 39999 but if I do that what do I compare this code??
Any thoughts or information would be greatly appreciated.

Thanks
Miriam
Upon further inspection there appeared to be mucinous implants along the right hemidiaphragm. I had Dr. XX of pathology come to the operating room and we discussed the case. I then decided to perform a right hemicolectomy and biopsy of the diaphragm. The cecum, appendix, terminal ileum were all identified, and then mobilized along the peritoneal reflection completely across the midline. I was able to include the area of the periappendiceal mucin by peeling off the peritoneum of the right midabdomen. The proximal transverse colon was mobilized from about the mid transverse colon to the hepatic flexure. The entire hepatic flexure was taken down, visualizing the duodenum. Once the entire right colon was mobilized over the midline, the periumbilical incision was extended, and the bowel was exteriorized. The terminal ileum and the colon distal to the tumor site were both transected with a GIA75 stapler. The mesentery was taken down with the LigaSure vessel sealing device. It was passed off as specimen. A side-to-side, functional end-to-end staple anastomosis was then performed with the GIA 75 and a TA 60 stapler. Multiple "crotch sutures" were placed to align the bowel and prevent kinking. Portions of the staple line were oversewn. The bowel was returned to the abdomen. The biopsy of the diaphragm was then performed bluntly with a Swanstrom grasper. The omentum placed over the anastomosis, the anastomosis placed in the right upper quadrant and the bowel returned in an orderly fashion so there would be no significant kinking. The abdomen was closed with a #1 PDS in a running continuous manner. T
 

mfournier

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Yes sorry that's what I meant to say (not 39999) but I need to compare it to another code???? since it is unlisted
 
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