Hi, need help with coding. Physician descriptionof procedures are Hand assisted laparoscopic radical right nephrectomy, adrenal sparing, complicated. Laparoscopic IVC tumor thrombus extraction. En bloc laparoscopic right paracaval lymphadenectomy. Umbilical hernia repair.
I know the lap right radical nephrectomy is 50545 but I can't find a code for the lap ivc tumor thrombus extraction. The open procedure 50230 includes the vena caval thrombectomy but the description for the laparoscopic code 50545 doesn't include that in the description. Should I be billing for the thrombus extraction separately? There isn't any code for laparoscopic but my doc is suggesting 34401.
Here is a description of partial op report; Right renal artery was then secured using the endo GIA stapler, vascular load, obtaining excellent hemostasis. The tumor thrombus could be seen in the inferior vena cava, after securing the renal artery, I was able to milk the thrombus back into the right renal vein. this allowed me to carefully place a second endo GIA stapler around the right renal vein at its insertion to the inferior vena cava while ensuring the tumor thrombus was completely placed into the renal vein. This was technically very difficult.
Any suggestions are appreciated.
I know the lap right radical nephrectomy is 50545 but I can't find a code for the lap ivc tumor thrombus extraction. The open procedure 50230 includes the vena caval thrombectomy but the description for the laparoscopic code 50545 doesn't include that in the description. Should I be billing for the thrombus extraction separately? There isn't any code for laparoscopic but my doc is suggesting 34401.
Here is a description of partial op report; Right renal artery was then secured using the endo GIA stapler, vascular load, obtaining excellent hemostasis. The tumor thrombus could be seen in the inferior vena cava, after securing the renal artery, I was able to milk the thrombus back into the right renal vein. this allowed me to carefully place a second endo GIA stapler around the right renal vein at its insertion to the inferior vena cava while ensuring the tumor thrombus was completely placed into the renal vein. This was technically very difficult.
Any suggestions are appreciated.