Wiki intraoperative hemorrhage

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mmoore70

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I need help coding the following procedure: 1. Attempted Laparoscopic Nissen fundoplication 2. Laparotomy with open field completion of Nissen fundoplication and securing splenic hemorrhage. I've spent at least an hour and half trying to figue out the intra-operative hemorrhage code. I came up w/ cpt 43327 w/Dx codes 530.81 & 998.11. Op report states the physician spent extensive time in surgery but does not give the time.
I would appreciate any help I could get. I hope I provided enough information needed for someone to assist me on this.. Thanks!
 
It sounds to me that the surgeon caused the bleeding during the laparoscopic portion of the procedure? If so, then it's not billable. You might consider a 22 modifier with V64.41 (lap converted to open) to justify this.

Please post the scrubbed op note
 
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