One of my surgeons was told by a colleage that he can bill 44950 instead of 44970 for single incision lap appy and it pays more. I let our surgeon know reimbursement varies depending on the insurance, but I think either code would be sufficient based on the way the surgery is done. I appreciate your suggestions.
Here's an op note example:
An open technique was used to place a 5 mm port at the umbilicus. An additional 5 mm port was placed lateral to this and falls at the umbilical incision. The 5 mm 30 degree camera was introduced. The lateral attachments to the cecum were bluntly dissected to mobilize the cecum. A 0 PDS suture was then passed between the two ports to create a U through the fascial bridge. Then the wound protector was then placed over a Prestige grasper. The Prestige was then used to grasp the tip of the appendix. The abdomen was desufflated. The ports were removed. The PDS suture was retracted to use cautery to divide the fascial bridge. The wound protector was then advanced into the lumen of the fascial incision and deployed to retract. The appendix was then delivered from the wound. The mesoappendix was divided with a vascular stapler and the appendix was dissected down to its junction with the cecum and divided. The stump was placed back in the abdomen. The cecum was placed back in its normal anatomic position. The wound protector was removed. The fascia was closed with 0 Vicryl suture in a figure-eight fashion. The umbilicus was tacked to the anterior abdominal wall. The skin was closed with running 4-0 Monocryl.
Thanks for your opinions.
Here's an op note example:
An open technique was used to place a 5 mm port at the umbilicus. An additional 5 mm port was placed lateral to this and falls at the umbilical incision. The 5 mm 30 degree camera was introduced. The lateral attachments to the cecum were bluntly dissected to mobilize the cecum. A 0 PDS suture was then passed between the two ports to create a U through the fascial bridge. Then the wound protector was then placed over a Prestige grasper. The Prestige was then used to grasp the tip of the appendix. The abdomen was desufflated. The ports were removed. The PDS suture was retracted to use cautery to divide the fascial bridge. The wound protector was then advanced into the lumen of the fascial incision and deployed to retract. The appendix was then delivered from the wound. The mesoappendix was divided with a vascular stapler and the appendix was dissected down to its junction with the cecum and divided. The stump was placed back in the abdomen. The cecum was placed back in its normal anatomic position. The wound protector was removed. The fascia was closed with 0 Vicryl suture in a figure-eight fashion. The umbilicus was tacked to the anterior abdominal wall. The skin was closed with running 4-0 Monocryl.
Thanks for your opinions.