AAPC - Back to school
Results 1 to 5 of 5

Thread: 38100 vs 38102 splenectomy

  1. #1

    Default 38100 vs 38102 splenectomy

    AAPC: Back to School
    I was wondering if anyone had input on which of these codes would be more appropriate in this case. Must I use 38102 or can 38100 be billed out with mod 59 secondary to 44120 in this case?

    PREOP DX: Ruptured Spleen
    1. Splenic capsule rupture
    2. Small bowel mass

    1. Splenectomy
    2. Small bowel resection.

    FINDINGS AT SURGERY: Significant intraabdominal blood, as well as a ruptured spleen and small bowel tumor (pathology showed malignant).

    PROCEDURE IN DETAIL: The patient was brought to the operating room after proper identification, confirmation of PARQ. After stabilization by the anesthesiologist, patient was then prepped an draped in normal sterile fashion. Midline incision was made, carried into the abdominal cavity. Upon entry into the abdominal cavity, left upper quadrant was packed iwth lap pads. At that point, the abdomen was then irrigated with copious amounts of normal saline and suctioned clear to clearly identify the spleen which had ruptured. It was clear that the spleen would not be salvageable since it was split down the middle, and the capsule was completely torn off. We then isolated the splenic hilum with 2 clamps. The end organ was removed, and then the splenic pedicle was then suture ligated with interrupted 0 silk suture. The abdomen was then irrigated with copious amounts of normal saline and suctioned clear. The left upper quadrant and the splenic region was inspected for hemostasis, which was well controlled. The abdomen was then explored. Due to his previous known abdominal pain, the small bowel was ran from the ligament of Treitz to the terminal ileum. We clearly identified a small bowel lesion which appeared to be a mass. It was likely the cause of his abdominal pain. Thus, a segmental resection was done. This was done by taking a wedge resection out of the mesentery with clear margins on either side of the lesion. The mesentery was then divided between Pean clamps. The proximal, distal bowel was divided with a GIA stapler, and then the specimen was removed from the table. The bowel was then reconnected by performing a side-to-side stapled end-to-end anastomosis with a GIA-75 stapler. The anastomosis was reinforced with interrupted 3-0 silkds as was the running 3-0 Vicryl. The abdomen was then irrigated with copious amounts of normal saline. The anastomosis was inspected for any signs of any vascular compromise which there was none. The abdomen was then further inspected for hemostasis, which was well controlled and the decision was made to close.

  2. #2


    hey there! i bill general surgery as well, and i spoke with another gal on my team and we say go with the 38100 and the 44120. you shouldn't (shouldn't being the operative term!!) have to modify b/c 38100 states to list as a seperate procedure.

    Good Luck!


  3. #3


    THANKS for your input!!


  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default 38102

    I'm not an expert in this, but ...

    38102 is an add-on code that specifically is intended to be used when there is a need for a total excision of the spleen, in conjunction with another procedure.

    The fact that 38100 has (separate procedure) noted does NOT mean that you should bill it separately without any modifiers. If you look at CPT 2009 Professional Edition, pg 47, under Surgery Guidelines you will find a paragraph that explains the meaning of Separate Procedure. I quote in part: The codes designated as "separate procedure" should not be reported in addition to the code for the total procedure or service of which it is considered an integral component. (emphasis added by FTB)

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  5. #5


    That was my original feeling as well, but because the two procedures were not related at all I felt like possibly the 38100 could be billed separately as my coding companion indicates "when performed alone or with other unrelated procedures they may be reported. If performed with other procedures, list the code and append mod 59.

    I felt like because they went in an did the splenectomy and then ran his bowel due to previous abdominal pain and then found the cancer and had to do the resection, that maybe this would qualify for code 38100 rather than 38102.

    What do you think?
    Also, this is for medicare.
    Last edited by Jarts; 03-20-2009 at 02:47 PM. Reason: added ins info

Similar Threads

  1. Splenectomy Code
    By drhoads in forum General Surgery
    Replies: 2
    Last Post: 02-26-2013, 10:22 AM
  2. Status splenectomy
    By NaliniAAPC in forum Diagnosis Coding
    Replies: 4
    Last Post: 01-08-2013, 04:12 PM
  3. Cpt code 48140 and 38100
    By deannamlove in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 03-29-2012, 03:24 PM
  4. 38100 vs 38102 splenectomy
    By Jarts in forum Gastroenterology
    Replies: 1
    Last Post: 03-25-2009, 10:22 AM
  5. Splenectomy add on/Inc?
    By acbarnes in forum General Surgery
    Replies: 0
    Last Post: 12-28-2007, 01:55 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.