Wiki Robotic assistance Coding

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pwilson

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It was recently mentioned by a coder within my system that coding ethics required an additional code for Robotic Assisted Procedures. In this case an unlisted code is being attached. I was under the impression that only the base code for the procedure was required. Does anyone have any information on this?
 
Not sure what you mean by "coding ethics" requires an additional code for robotic assisted procedures. There is a HCPCS code, S2900 to indicate robotic assistance. I will note that none of my payor contracts allow additional payment for this. It is used for tracking purposes only. The use of S2900 may vary from employer to employer.
Robotic assisted procedures are typically laparoscopic, with the daVinci simply being a tool used to accomplish the laparoscopic procedure. Which are then coded as laparoscopic. I use unlisted only when there is no laparoscopic code to describe the procedure being performed. Using the daVinci does not add expense for the surgeon, and the laparoscopic procedure is already valued accordingly for skill and time.
Coding laparoscopic PLUS unlisted would be incorrect. Coding laparoscopic PLUS S2900 is permitted per coding guidelines, but will likely not change your reimbursement.
If you have a specific type of surgery with codes as an example, that could be helpful.
 
csperoni said:
Not sure what you mean by "coding ethics" requires an additional code for robotic assisted procedures. There is a HCPCS code, S2900 to indicate robotic assistance. I will note that none of my payor contracts allow additional payment for this. It is used for tracking purposes only. The use of S2900 may vary from employer to employer.
Robotic assisted procedures are typically laparoscopic, with the daVinci simply being a tool used to accomplish the laparoscopic procedure. Which are then coded as laparoscopic. I use unlisted only when there is no laparoscopic code to describe the procedure being performed. Using the daVinci does not add expense for the surgeon, and the laparoscopic procedure is already valued accordingly for skill and time.
Coding laparoscopic PLUS unlisted would be incorrect. Coding laparoscopic PLUS S2900 is permitted per coding guidelines, but will likely not change your reimbursement.
If you have a specific type of surgery with codes as an example, that could be helpful.
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Thank you, "Coding Ethics" was used by the coder I queried. This is a system wide question we had so I was just looking for input in general. I appreciate your answer.
 
Agree with Christine's advice. Just wanted to give some policy examples. You can "code" it but it's not going to be paid. Where I have worked we did not bother coding it. Some places may want to for tracking purposes internally. It's integral to the procedure. I can kind of see what the coder may be saying, that maybe they were trained to "code out" everything that was done. However, if your practice or facility has an internal policy and depending on how your claims go out, you may or may not want to code "everything". Some places are set up to exclude "non-billable" codes on the claim but they track them internally for RVUs or other reasons such as reporting. I think this is just a conversation to discuss with the employee. They aren't totally wrong. Not sure if I would really call it coding ethics. It's more a procedural difference of the book or school way versus the real world and RCM.

This is from a vendor, always beware when following their advice. https://www.zimmerbiomet.com/conten...ing-Reference-Guide-for-Joint-Replacement.pdf

Old but info: https://www.aapc.com/blog/28266-coding-robot-assisted-surgery/
 
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