Wiki TLH with mini-Laparotomy incision

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scurtis7189

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The physician started a hysterectomy with a laparoscopic approach. The uterus was over 500 grams and a mini-laparotomy incision was made to remove the specimen. The laparotomy incision was then closed and the procedure was finished as a laparoscopic hysterectomy.

What CPT code should be used in this situation?

Thank you.
 
scurtis7189 said:
The physician started a hysterectomy with a laparoscopic approach. The uterus was over 500 grams and a mini-laparotomy incision was made to remove the specimen. The laparotomy incision was then closed and the procedure was finished as a laparoscopic hysterectomy.

What CPT code should be used in this situation?

Thank you.
Click to expand...
Hey did you ever figure this one out? I know it was from so long ago. I've just come across this for my practice
 
When a procedure is PERFORMED laparoscopically, it should be coded that way. An enlarged incision only to remove the specimen, without doing any part of the actual surgery through the open incision is not a conversion to open. Depending on documentation, it is possible -22 is warranted on 5857X.
If the procedure begins laparoscopically, and the physician must open the patient and PERFORM the surgery or remaining surgery via the open abdomen, it is then coded as open. Also adding the diagnosis for laparoscope converted to open. Again, depending on documentation, it is possible -22 is warranted on the open hysterectomy code.
Here were some other threads discussing:
And some other web references:
 
csperoni said:
When a procedure is PERFORMED laparoscopically, it should be coded that way. An enlarged incision only to remove the specimen, without doing any part of the actual surgery through the open incision is not a conversion to open. Depending on documentation, it is possible -22 is warranted on 5857X.
If the procedure begins laparoscopically, and the physician must open the patient and PERFORM the surgery or remaining surgery via the open abdomen, it is then coded as open. Also adding the diagnosis for laparoscope converted to open. Again, depending on documentation, it is possible -22 is warranted on the open hysterectomy code.
Here were some other threads discussing:
And some other web references:
Click to expand...
Thank you so much!!!
 
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