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Cholecystectomy with Liver Resection

  1. #1
    Pittsburgh Central
    Question Cholecystectomy with Liver Resection
    Medical Coding Books
    A patient has severe chronic cholecystitis, cholelithiasis, and hydrops of the gall bladder. The surgeon is performing an open cholecystectomy (47600) and states that the back wall of the gall bladder has eroded into & is densely adherent to the liver. Because of this, he removes the gall bladder along with the central portion of the liver (47120).

    Per CCI, 47600 (column 2) cannot be coded with 47120 (column 1).

    I'm thinking of going with 47600-22, any other suggestions?

    Thanks in advance!

  2. #2
    Johnson City
    I'm thinking that you should not code the liver resection, as you said it is bundled per the NCCI edits. My logic is: the reason for removal of the liver was because the gallbladder was adhered to it. So in order to remove the gallbladder they had to take some of the liver.

    If the circumstance were for instance, While removing the gallbladder your doctor noticed a suspicious lesion on the liver and performed a liver resection. Then I would say code it and use modifer 59 to unbundle it.
    Melissa Jewett, CPC

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