My surgeon discontinued a laparoscopic cholecystectomy due to extensive adhesions and the possibility of a CD stone and proceeded with a open procedure with and intraoperative cholangiogram. What is the appropriate coding for this surgical procedure? In addition to the open cholecystectomy code, can I use the 52 modifier with the Lap code? or should I use 53? Thanks for your input!
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Wiki Modifier 52 or 53 - cholecystectomy
- Thread starter dlk
- Start date
FTessaBartels
Guest
Code only open procedure
When you convert a lap procedure to an open procedure, you code ONLY the open procedure. Use V64.41 as a secondary dx.
F Tessa Bartels, CPC, CEMC
When you convert a lap procedure to an open procedure, you code ONLY the open procedure. Use V64.41 as a secondary dx.
F Tessa Bartels, CPC, CEMC
Tessa,
I cannot remember who advised us to bill our lap to opens this way, but If we are attaching the operative note to the claim when we are submitting with a second code of 49320-59 and they are paying on it, are we committing some type of fraud?
We obviously don't want to be doing something inappropriately but it seems odd the carriers would pay on this with all of our documentation if they did not feel it was appropriate. Just looking for some insight so we don't continue to code this way if it's definitely a no no.
Thanks,
Julie
I cannot remember who advised us to bill our lap to opens this way, but If we are attaching the operative note to the claim when we are submitting with a second code of 49320-59 and they are paying on it, are we committing some type of fraud?
We obviously don't want to be doing something inappropriately but it seems odd the carriers would pay on this with all of our documentation if they did not feel it was appropriate. Just looking for some insight so we don't continue to code this way if it's definitely a no no.
Thanks,
Julie
iluvicd9
Guest
Lap to Open
If the physician converts from a lap procedure to an open procedure, you should only code for the open procedure.
If the physician converts from a lap procedure to an open procedure, you should only code for the open procedure.
dmaec
True Blue
it's fraud when you KNOWINGLY code incorrectly (getting paid for something that is knowingly wrong)..
so, now - IF you continue to do it, (knowing it is wrong)...it becomes FRAUD.
gather your info on it. When converting from lap to open, you code only the open. Don't be attaching the .59 to the lap procedure.. code only the open.
so, now - IF you continue to do it, (knowing it is wrong)...it becomes FRAUD.
gather your info on it. When converting from lap to open, you code only the open. Don't be attaching the .59 to the lap procedure.. code only the open.
